Medical Billing Blog with Medical Billing & Coding Info & Articles
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Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding, ICD, HIPAA and practice management functions.
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Using Care When Using Modifier 24
If you are a practitioner or medical biller that has a client who sees patients in need of services for post operative complications and you are bundling the services into the global period of surgery, you could possibly be missing thousands of dollars in reimbursements yearly using this method of doing your medical billing. In many cases you can legitimately report patient evals made during the post-op period, according to the individual carrier’s rules. A good rule of thumb for most carriers is if the post operative complication evaluation is unrelated to the original procedure and this can usually be distinguished by medical necessity and date alone, then you can …
Correct Billing for Same Day Services
Medical billing for same day services can sometimes be confusing. Only skilled professionals can tell the difference between same day services and code them correctly. A good example of same day services that can be confuses involve fine needle aspiration (FNA). If a FNA is performed on the same day as a more extensive procedure, the Centers for Medicare & Medicaid Services will only pay for the procedure that is more invasive. This is called the “sequential procedures policy” in medical billing. This usually occurs when a physician decides to do a FNA, but later after the procedure, decides it did not accomplish what it was supposed to. That same …
Correct Medical Billing Reimbursements for Power Mobility Devices
Due to the unfortunate incidence of fraud, there are some strict medical billing requirements for getting reimbursed for power mobility devices. Additionally, the time the physician spends working on the extra documentation is also billed at the current rate of an extra $21.60 for the extra time spent on power mobility medical billing. Recently there was an increase in the amount of documentation that is needed to do medical billing for power mobility devices. Medicare requires the prescription, patient’s medical records and any other supporting information. Instead of lowering the amount of medical billing documentation for power mobility devices, Medicare decided to properly compensate for the extra time it creates. …
Medicare to Conduct Reviews for Medical Billing Overpayments
The states of New York, California, and Florida are involved in a pilot demonstration led by the Centers for Medicare & Medicaid Services. The Centers for Medicare & Medicaid Services has hired a Recovery Audit Contractor (RAC) to do extensive evaluation of medical billing claims for three years. You may be asking: What does this medical billing audit mean to your practice if you don’t reside in one of those states? If the demonstration in these three states is successful and the Centers for Medicare & Medicaid Services are able to recover money in medical billing overpayments, it could mean a lot to your practice. It would mean that the …
Correct Medical Billing for Endoscopy Procedures
Endoscopic procedures are getting a closer look by Medicare and Medicaid. The University of Rochester’s Strong Memorial Hospital submitted claims from September 2001 to December 2003 for endoscopic procedures that were found in an audit conducted by both agencies to be billed incorrectly. In total costs, the hospital repaid over $500,000 combined to these organizations. There were two main reasons the medical billing was incorrect. Many of the procedures claimed that the head of surgeon, Ma Sundaram, performed the surgeries. In all actuality, most of the time, the head surgeon was not even present. The other reason the medical billing was incorrect was because medical necessity was not substantiated for …
