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-10, HIPAA and all practice management functions.

Click any of the article links below or browse by section to the right to read articles on a specific subject.

Currently contains over 1,235 healthcare and medical related entries.

View a complete list of all entries

Bill One or Bill Twice for 97001/97002?

Patient evaluation codings can be very confusing. The patient initial evaluation code is 97001 (also, 97003, 92506, 92610) however if the patient is reevaluated (97002- patient reevaluation) within a 12 month period only one unit of service may be billed to Medicare Part B patients no matter how much time was spent actually servicing the patient. If you make a mistake and bill the carrier for the evaluation and a unit of service for the reevaluation, your claim will be denied based on incorrect coding no matter how much medical documentation you provide showing the necessity of the reevaluation of the patient. Keeping up with the fast paced changes of

Published By: Kathryn Etienne, CCS-P, RT | No Comments

Is It Time to Outsource Your Medical Billing?

If you are noticing your medical billing claims are taking longer and longer to be reimbursed or you are having denials, rejections, or only partial reimbursements on your medical billing claims, it may be time to look at outsourcing your medical billing claims. You may feel as though you would be giving up control of your cash flow when actually you will have more control than ever. In fact, outsourcing your medical billing and coding needs through a medical billing partner is one of the smartest business moves you can make. The best company to handle your medical billing isn’t necessarily located around the corner from your practice or even

Published By: Kathryn Etienne, CCS-P, RT | No Comments

Two Removals are Similar and Different

To avoid raised rejection of your medical billing claims for similar procedures that will be coded due to different removals or different parts of the body affected, you need to make sure you have iron-clad documentation. In some cases, you will come across two removals that are very similar, but different. For example, if a pediatrician removes an extra digit from a newborn’s hand, and also removes a skin tag from the newborn, the removal of an extra digit and the removal of a skin tag fall under the same CPT code but fall into different ICD-9 codes. For these two procedures, you should report 11200 (11200 is the removal

Published By: Kathryn Etienne, CCS-P, RT | No Comments

New HCPCS Medical Billing Tool

Your practice should know where to look for medical billing changes each year. When dealing with HCPCS consolidated billing, many billers become confused about what codes are excluded from this type of billing. Before allowing your staff members to do medical billing, be sure they know where to look for answers to their coding questions. The source to find consolidated HCPCS medical billing codes is no longer in the Centers for Medicare & Medicaid Services’ Skilled Nursing Facility Help File. Since September 25, 2005, CMS has tried to steer medical billing staff members away from this file. Now, however, it is more important to do so. A new website has

Published By: Melissa Clark, CCS-P, RT | No Comments

Watch Out for New Medical Billing DNA Test

Keeping current with your medical billing codes could help your lab succeed. New tests and lab works are developed each and every year. Some of these new tests have a positive impact on your medical billing, while others have no impact at all. A new test call Fluorescence Chain Reaction (FCR) may have an extremely positive impact on your medical billing. Fluorescence Chain Reaction is a brand new lab test that checks human DNA. The amazing aspect of this test is the short amount of time needed to retrieve results. This method takes less than five minutes to produce accurate information. Although insurance payers may be more familiar with the

Published By: Kathryn Etienne, CCS-P, RT | No Comments

Medical Billing with 59025

Using the medical billing code 59025 can be a sticky situation. This is an example of a current procedural terminology code that is often misused in medical billing offices. There are certain instances when the code 59025 is appropriate, and other times it is not appropriate in medical billing. The medical billing code 59025 means fetal non-stress test. A non-stress test is used to detect accelerations in the fetal heart rate over a 20-40 minute window. If no accelerations are found, the physician uses instruments to stimulate the baby or wake the baby up into a moving state. To be considered a true non-stress test in medical billing, these elements,

Published By: Melissa Clark, CCS-P, RT | No Comments

Medical Billing Conversion Factor Cut 4.4 Percent

Medical Billing Conversion Factor Cut 4.4 Percent Medical billing reimbursements are looking dismal for 2006. Although inflation rises, the Medicare conversion factor will lower from 2005 to 2006. You may need to find other areas in your practice to compensate for medical billing reimbursement loss. In early November of 2005, the Centers for Medicare and Medicaid services released the 2006 fee schedule for physicians. The Medicare conversion factor, that has a lot to do with payment fee schedules, was slashed by 4.4%. The medical billing conversion factor and relative value units are the two major factors used in the schedule construction. In 2005 the conversion factor was 37.8975. This year,

Published By: Kathryn Etienne, CCS-P, RT | No Comments

Medical Billing Mesh

Medical Billing Mesh Mesh placement medical billing can be a mess. Hernia repairs are very common, therefore mesh placements are very common. To keep your mesh placement medical billing accurate there are four steps to follow. There are many different types of hernias. Mesh placement in medical billing is only allowed for two types: ventral and incisional hernia repairs. The first step to correctly do medical billing for mesh is to be sure the surgery was a ventral or incisional hernia repair. The second medical billing step for mesh placement is similar to the first step. You must always remember that any other hernia repair will not reimburse separately for

Published By: Melissa Clark, CCS-P, RT | No Comments

Subscribe To Article Updates By Email

Submit this form to receive an email when a new article is published to our blog.

Your email address:

(Your email will never be given or used for anything but this article subscription) - privacy policy