Medical Billing Blog: Section - Outsourcing
Archive of all Articles in the Outsourcing Section
This is the archive containing links to all articles written in the Outsourcing section of our blog.
Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.
Code Designations Determine When to Use Modifier 59
When do I use medical billing modifier 59? This is a great question. It is one that many don’t ask, but most don’t know the correct answer to. One of the most important things to know about the medical billing modifier 59 is which code on which to append it. There are some basic medical billing rules that can teach you which code to use with modifier 59. The general assumption about modifier 59 (Distinct procedural service) is that it should be linked to the lower-valued code of the pair. Although this may be true a lot of times, it is not always true. There is a much better rule …
The Inside Scoop on Medical Billing for Tissue Adhesives
Coding for tissue adhesives can be confusing because there isn’t one set procedure for this. The coding that is used is determined by the type of wound and the severity of the repair when tissue adhesives are used for wound closures. The answer to this question will be different depending on which entity is paying the medical billing claim. When you code for the use of tissue adhesives, including Dermabond; Medicare has its own guidelines for reporting this procedure that you need to follow to be reimbursed. You should report G0168 for Medicare patients only. If you are reporting the procedure for a non-Medicare patient, you should use the CPT …
Gastric Bypass Codings Becoming More Common
As a medical biller, you may be seeing an increase in the number of gastric bypass claims that you are handling as more and more insurances are covering this procedure as a measure to remove the patient from danger of developing more serious, chronic and costly illnesses that can stem from being grossly obese. After a patient has undergone gastric bypass surgery, eventually they will have the band removed. Many medical billing professionals are amiss at whether to include modifier 59 with their claim in order to obtain reimbursement for the procedure. Under The Correct Coding Initiative (CCI), normally the procedure of removing the band and port removal would be …
Separating Payments on Separate Tests Performed
Did you know that you can actually bill separate tests performed from your practice for separate payments? Certain practices have been taking advantage of larger reimbursements by doing just that. Say that you have a patient that is new to your practice and they are coming in for an exam. You can both bill for that exam and then bill separate for any other tests or screenings that they will be having performed. Although you may feel as though you are doing something wrong when it comes to medical billing practices such as these. However, the important Centers for Medicare and Medicaid services have been doing a good amount of …
Using Place of Service Codes Correctly
More and more carriers are cracking down on medical billing claims that have a lack of or incorrect place of service code. Even with the correct current procedural terminology code for E/M services, a medical billing claim that does not have a correct POS code will get your claim denied. It is a common occurrence in medical billing for the place of service codes to be misused or left out. There are several current procedural terminology codes for an evaluation and management session that correspond to different medical billing place of service codes. When using CPT 99341 (Home visit for the evaluation and management of a new patient) through 99350 …
