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.
2004-2024 Celebrating 20 Years of Healthcare RCM Articles
The Blog Currently Contains 1,265+ Healthcare Articles
Correctly Using Modifier 59
Modifiers can be a helpful addition to medical billing. However, there are certain modifiers that are constantly used incorrectly. The contractors for the Centers for Medicare and Medicaid Services are now keeping an eye out for suspicious modifiers. The medical billing modifier 59 is on the list of modifiers to flag for review. Recently, the U.S. Office of Inspector General released a report that showed some daunting medical billing news. Modifier 59 has been the cause of over $59 million in overpayments to nursing homes and providers. Due this large number of overpayments, Medicare contractors will be closely scrutinizing each medical billing submission that contains the modifier 59. To prevent …
Correct Medical Billing for Family Meetings
If you have a meeting with the family members of an assisted living facility patient (patient was not present) to discuss any aspect of the individual’s healthy status, such as memory loss or personality changes, you can bill Medicare but this scenario would not qualify for CPO (Care Plan Oversight) services. Instead this would fall under the realm of code range 99324-99337,(Domiciliary or rest home visit for the evaluation and management of a … patient). By the way, when you do report CPO services for a private-pay assisted living facility patient in the near future, you would assign new 2007 codes 99339-99340 (Individual physician supervision of a patient [patient not …
Correct Usage of 99336
Rest home care medical billing can be very tricky. Many coders bill for at home services or nursing home services when rest home care is performed. Incorrect medical billing coding such as this, could get you into trouble. Make sure your staff is up to date on the new medical billing coding regulations that addresses the specific guidelines for rest home coding. The place of the service is a big issue when dealing with the rest home services. Rest home, or custodial care facility is labeled as a POS 33. This is defined as a facility that provides room, board and other personal assistance services generally on a long-term basis. …
Using 92630
Aural Rehabilitation has caused a lot of confusion regarding how to do the medical billing correctly for the best reimbursements. Additionally, medical billing changes to Aural Rehab CPT codes have incorrectly caused many people to believe Aural Rehabilitation is not covered. Medicare actually assigned status code “I” to all new medical billing codes for auditory rehabilitation. These codes are 92630 and 92633. This means that the Centers for Medicare and Medicaid Services will not pay for auditory rehabilitation, only diagnostic audiology. However, this is only true if an audiologist performs the service and the medical billing. There are several other medical professionals that could possibly perform medical billing for aural …
Bigger Reimbursements for 92626
Medical billing in the speech, language, and hearing community is looking a little more lucrative. A transmittal released by the Centers for Medicare and Medicaid Services announced a dramatic increase for reimbursement for the Current procedural terminology code 92626. Medical billing reimbursement will be nearly four times the old amount for this code. The current procedural terminology code 92626 (Evaluation of auditory rehabilitation status; first hour) was reimbursable at $22.07. This has changed. Medical billing now allows this code to be valued at $81.76. The relative value unit (RVU) used to calculate this medical billing reimbursement was 2.20. Originally the RVU was 0.55. The American Speech Language Hearing Association (ASHA) …
