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
Reasons For Medical Billing Reversals
Reasons For Medical Billing Reversals Reversals can happen for a myriad of legitimate and not so legitimate reasons. In a recent study, the top reasons for medical billing reversals are as follows: 1- Incorrect payable diagnoses codes, the biggest offenders in this category were: Modifier 59 – distinct procedural serviceModifier 76 – repeat procedure by same physician Modifier 24 – unrelated evaluation and management service by same physician during postoperative periodModifier 25 – significant separately identifiable evaluation and management service by same physician on the day of a procedure. 2-Provider Billing Errors – As long as medical billing is coded by humans, there will be errors, that’s just a fact …
Payers Treat Group Practices as 1 Provider
Payers Treat Group Practices as 1 Provider Medical billing rules can get hazy when dealing with group practices. It is difficult to determine if physicians within a group should bill separately for follow up care if another physician performed the actual surgery. There are rules to follow in this type of situation that make medical billing easier to understand. When there is a group of physicians in the same practice, usually one does surgery. With surgery there is usually follow up care that is bundled in the CPT code for medical billing. This means that surgeons cannot bill separately for follow up care and for the surgery. This also goes …
Hospital Coding For Medical Billing Claims
Hospital Coding For Medical Billing Claims Hospitals can be fast paced, shift changes and sometimes the lack of documentation can all hinder the reimbursement process for your medical billing claims. Hospital coding techniques can vary greatly since so many individuals handle the coding and documentation and usually they require a good deal of overview. Medical billing for out patient and X-ray labs is usually very cut and dried to process as you only need to check the orders for necessity (especially for Medicare medical billing claims) and you need to make sure you have the proper documentation prior to submitting your medical billing claims. Asking for missing information in order …
What are Taxonomy Codes?
What are Taxonomy Codes? Even if you’ve only been involved in medical billing for a short time, you have seen taxonomy codes, they are primarily used in the billing of Medicare claims. The taxonomy code is now HIPAA mandatory and necessary for electronic filing of medical billing claims. The taxonomy is a unique alphanumeric code that is 10 characters in length. The code list is structured into three distinct “Levels” including Provider Type, Classification, and Area of Specialization. There is a listing called “The Provider Taxonomy Code List” which allows a single provider (individual, group, or institution) to identify their specialty by category. Providers may have one or more than …
Wound Length & Medical Billing Laceration Claims
Wound Length & Medical Billing Laceration Claims When processing medical billing claims for multiple laceration repairs – which is common when processing paperwork on an auto accident and many emergency room claims; normally you won’t add the repair lengths unless you have wounds that require exactly the same type and amount of care and are at roughly the same anatomic location as defined by CPT coding. The medical billing is easy enough to figure out on most multiple laceration claims. If there are different types of repairs you will use separate CPT codes on your medical billing. If you have multiple lacerations in the same area, CPT explains this by …
