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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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The Blog Currently Contains 1,265+ Healthcare Articles
Three Questions Solve IM Injection Medical Billing Challenges
CPT 2006 injection administration coding instructions require that you verify the OB-GYN’s involvement in order to report 90772, or in order to submit the non physician performed procedure as 99211, or it could depend on the payer’s incident-to policies, and possibly be returned to you as a no charge. To determine which code applies to injection administration, you need to ask yourself three questions. 1. Is the Doctor in the office and available during the injection? If the answer is yes, the OB-GYN provided direct supervision throughout the subcutaneous or intramuscular injection, then you can report 90772 (which is therapeutic, prophylactic or diagnostic injection (specify substance or drug); subcutaneous or …
3 Ways to Ease Modifier 25 On Your Medical Billing Claims
The AMA provides some helpful clarification on when to append modifier 25 in CPT 2006, but you might still need a little more information on how to ace those claims. Here are three tips to help you out. Report only significant services. In order to gain separate payment for an E/M service, the physician provides at the same time as he or she provides another service or procedure, the E/M service must be significantly and separately identifiable. All procedures include an inherent E/M component according to CMS guidelines. Any E/M service you report beyond that must be above and beyond what is normally included with that procedure or service. Always …
How to Dx More Than One Severity Level on Your Medical Billing Claim
Example: a patient presents with both first and second degree burns on their face. You should report only the more severe (in this case second degree) burns when assigning diagnoses for burns in the same anatomical location. For example, the codes beginning with 941 describe the face, head and neck burns. For burns to the trunk, you would use the 942 series, and codes 943, 944, and 945 are for burns to the arms, hands, and legs, respectively. Remember that you should never report a first degree burn separately with the 941-946 series if there are more severe burns on any other part of the body, except when treatment is …
Medical Billing News -AMA Eliminates Modifier Hyphen
You may have noticed in recent coding alerts that there is no hyphen included before a modifier. The AMA has done away with using hyphens before modifiers. This change occurs in CPT’s coding manuals and CPT assistant as well. The AMA used the hyphen as a formatting convention in order to ensure that people realized that an upcoming number was a modifier. The symbol avoided numerical confusion as well. The hyphen would alert a reader that the last two digits, such as “-25” were not a part of the CPT code. This should not be a huge change, since most people are most likely used to looking at modifiers without …
Three Rules for Observation Medical Billing Coding
There are three rules that govern observation coding. Let’s use for example a case in which a surgeon admits a patient for observation at 9 p.m. and releases the patient the next day, at 1 a.m. Follow these three rules, and you will be all set. 1. If a physician admits a patient for observation and releases the patient on a different date of service, if the total duration of the observation stay is more than eight hours, you should report 99218-99220 with 99217. If a stay lasts multiple days, you may report one unit of 99218-99220 for each date of service, except the date when they physician discharges the …
