Medical Billing Blog with Medical Billing & Coding Info & Articles

Welcome to the Medical Billing and Coding Blog

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

The Controversy about 99058

In the latest revision for 2006, CPT has revised one code (99050) for after hours services performed by physicians and hospitals and added several more codes to designate specific times and places of services rendered. There is one code in the new listing, that is already causing some controversy as to when it is the proper time to use. It is 99058 and it is Schedule Disruption” due to an emergency situation. By the very nature of health care, there are many emergency situations and the code caused confusion from its debut. The AMA has amended the definition to mean that an emergency is defined by any event that disrupts

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

About 99053 and 99058 for your Medical Billing

There are new codes issued in the CPT 2006 that specifically designate after hours and red-eye services for procedures done by physicians outside the normal hours. Previously when compiling the medical coding for medical billing, a coder would have used 99050 as a “catch-all” coding. Now CPT has revised the original code and added new codes. 99053 is ” “for services between 10 p.m. and 8 a.m. in 24-hour facilities,” and will be used by both physicians on call and hospitals. Please note that code 99053’s wording to include “24-hour facility” will put a new limitation on using late night service codes. Previously a coder would have simply used 99052

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

In the Beginning of Medical Billing: Medical Coding

Many people assume that medical billing and medical coding are one in the same procedure. However as you in the industry know, they are part of the same process, but very different. Medical coding is where medical billing begins and couldn’t be processed without it. When a physician or hospital renders services, a code is assigned to that procedure or procedures. The more services that are performed for a patient, the more medical billing codes there will be. Those codes are recorded on a medical billing form. The tricky part is keeping up with the ever-changing nature of the medical billing codes. These codes can be changed/added to/or removed many

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

Correct Medical Billing for Foreign-Body Removal

Foreign body removal is another scenario that winds up with a lot of rejections or reduced reimbursements. One of the biggest reasons is that when the coding is being done on the claim. The part of the body affected isn’t addressed in the medical billing claim. If a foreign body was removed from a patient’s eye, then the code for simple foreign body removal should not be used. The specific coding for removal of conjunctival foreign bodies which is code 65205 (Removal of foreign body, external eye; conjunctival superficial) or 65210 (conjunctival embedded [includes concretions], subconjunctival, or scleral nonperforating). Notice that these codes do not refer to any particular instrument

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

Medical Billing for Ob-Gyn Claims Made Easy

As you know, the CPT 2006 injection coding instructions now require that the ob-gyn’s presence be verified during an injection which is coded as 90772 or the procedure must be reported as a non nonphysician-performed procedure as 99211. The latter can result in a no-charge depending on the payer’s policies. You need to make sure you answer these questions: *Is the Doctor in the office and available at the time of injection?If you can answer yes, you can report this medical billing claim as 90772. If you cannot answer yes, then you have to use 99211 that is for injections given without direct physician supervision. The requirement does not mean

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