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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Special Medical Billing Dilemma

With multiple births becoming more and more commonplace, the reporting of twins on medical billing claims has become more routine and there are some special considerations when filing out your medical billing claims. If both babies are born by cesarean, bill only once. Remember, the doctor delivers all of the babies–whether twins, triplets, or more–by cesarean, you should submit 59510-22. Report 59510 with modifier 22 (Unusual procedural services) appended, because even though only one incision was made, the modifier will testify to the fact that multiple babies were delivered. Be sure and include your medical documentation as to the reason for the necessity of the cesarean. If the babies were

Published By: Melissa Clark, CCS-P on May 12, 2006

Reasons to Outsource Your Medical Billing Functions

If you’ve been feeling the stress and strain of too much paperwork and time spent preparing medical billing for your practice and not enough time is left to service your patients to help your practice grow, it might be time to consider outsourcing your medical billing claims. There are some sobering facts about medical billing claims that might give you pause to consider it might be time to outsource your medical billing. When you consider that healthcare providers averaged spending $7 billion annually just submitting claims to carriers. Another jaw dropping fact about your medical billing claims, is you might be missing being reimbursed for nearly 1/3 of your legitimate

Published By: Melissa Clark, CCS-P on May 11, 2006

Medical Billing for Nutritional Counseling

With obesity among patients rising at an alarming rate, the continuing counseling of patients who need nutritional information, especially for controlling their diabetic conditions is also on the rise and it is fast becoming a common coding in medical billing. If it can be reimbursed and how it can be reimbursed are two dilemmas that many physicians are finding confusing. If you’re not getting reimbursed for your patient counseling, you’re losing money for your practice. When an individual nutritionist consults with a patient in a non-certified physician setting, you’ll most likely report sessions with 97802-97804. But if your practice has an American Diabetes Association-approved program, you may also use Medicare-specific

Published By: Melissa Clark, CCS-P on May 11, 2006

Getting New Patient Office Visits Paid by Medicare

If a new patient presents in your office and it is determined through evaluation that a pap smear is necessary – Medicare will probably deny the claim unless you can show medical necessity of the preventative measure. You will need to use pap and a pelvic code with 99203 is if the patient presents with a problem that needs to be evaluated. Using code 99203 (Office visit) is not a substitute for the rest of a preventive exam (which Medicare generally does not cover). Use modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the

Published By: Melissa Clark, CCS-P on May 10, 2006

Medical Coding – The First Step to Medical Billing

Medical billing and medical coding go hand in hand and can seem very confusing until you learn how they work with each other. Medical coders take the procedures and services performed by doctors, hospitals and clinics and translate those services into a series of assigned medical codes that each carry a revenue amount that will be reimbursed when the form that the medical coder has filled out is completed, documented and submitted for reimbursement by the medical biller. There are codes for every conceivable type of encounter and even codes for having no code for the procedure. Whether it is a test, service, procedure, treatment or ongoing care, the service

Published By: Melissa Clark, CCS-P on May 10, 2006