Medical Billing Blog with Medical Billing & Coding Info & Articles
Our blog contains news and articles relating to numerous healthcare sectors including revenue cycle management, medical billing, medical coding, ICD, HIPAA, practice management functions and more.
Using Q Modifiers on Foot Care Claims
Make sure that you and your staff are up to date on using Q Modifiers as these were updated in 2007. Make sure you are getting the best reimbursements by using the currently preferred modifiers to be reported when the physician is performing foot care. Modifiers Q7 (One class A finding), Q8 (Two class B findings) or Q9 (One class B and two class C findings) tell insurers why your physician is performing foot care. To determine which modifier applies to your physician’s claim, check out the following list of what Medicare and other payers include in each description: Class A Finding:Nontraumatic amputation of foot or integral skeletal portion thereof …
Are You Reporting Circumcision With Nerve Blocks Correctly?
There are some new guidelines for reporting a nerve block with a circumcision. In the past you may have reported this as two separate procedures using 54150 to document the circumcision and 64450 for the accompanying nerve block. However the AMA has revised code 54150 (Circumcision, using clamp or other device with regional dorsal penile or ring block) in the new edition of CPT 2007 to include the accompanying nerve block in the description of the service. As such, it would now be unnecessary to report 64450 (Injection, anesthetic agent; other peripheral nerve or branch) with 54150 for this purpose, and the National Correct Coding Initiative (NCCI) bundles 64450 into …
Tips for Handling Critical Care Evaluation for Pediatric Medical Billing Claims
Pediatrics is one of the most complex areas of medical billing. It has many medical billing codes that were created just for the use of describing procedures. However, there are other areas of medical billing that do not have these specific codes for children. This can make coding hit or miss unless you know the nuances of what the carrier wants in order to get the maximum reimbursements for procedures performed. A common dilemma is with CPT code 99293 and its use for outpatient emergency room exams for an infant or if code 99291 should be used. The medical billing code 99291 means critical care, evaluation and management of the …
Been Hit With Medically Unlikely Edits Denials?
It can happen to any individual who is involved with coding, dealing with MUEs can end up being a nightmare if you do not know when and how to use them. MUEs, which is short for the term Medically Unlikely Edits, happen to be put in place to try and help limit the amount of billing errors. The more you understand them, the better off you will be when you find that you need to use them. If you are worried about dealing with MUEs, then you really should know that you are not alone. Luckily, there are a couple of things that you can look to and keep in …
Medical Coding for Multiple FB’s in the Same Site?
Foreign bodies as you are well aware present often as people get in all sorts of accidents at the home and on the job. From the splinter in the eye from the weekend warrior who decided he was too cool to wear safety glasses when he was building a table to the kid that came into the ER with multiple embeds under the skin; they are all reimbursable procedures and if you aren’t getting half or better reimbursements, then you need to brush up on your coding and make sure your medical billing claims are airtight. Generally, it is always best to use only one code for foreign body removal …
Questions About NCCI Edits for Unusual Situations
There have been questions regarding the use of carotid Doppler (93880) being performed on the same day as venous Doppler (93965, 93970, 93971); some insurance companies do not want to reimburse both procedures as it is unusual to perform both with one service period. National Correct Coding Initiative edits don’t prevent you from reporting these codes together, but the payer may be questioning the medical necessity of performing both services on the same day. Doctors don’t usually order both of these exams for the same patient on the same date of service. If there was a reason and you can show hard documentation as to the necessity of having both …
Correctly Coding the Top 4 Pediatric Parent Consultations
No one has to tell you that the world of pediatric medicine is fast paced and along with unpredictable kids come unpredictable medical billing situations. If you process medical billing for pediatric physicians, you may or may not have run across a situation for determining what diagnoses would apply when parents come in to discuss their child’s health issues. If you’re wondering if there is a single code, the answer is yes. A parent conference falls under V65.19 (Other persons seeking consultation; other person consulting on behalf of another person). In other words, the code describes a person seeking “advice or treatment for non-attending third party.” Since a parent has …
Sick Visit Claims Could Be Costing Your Practice
Did you know you might have a cash flow leak and not know it? It’s not uncommon for practices to file medical billing claims without meeting requirements for the use of Modifier 25 in bundled sick claims and doing so could very well be costing your practice valuable reimbursement revenue. Fortunately, there are some simple rules to follow to ensure that you’re getting the best reimbursements for your claims. First of all, make sure that you know exactly what the payer requires for reimbursement on these claims. Next, make sure you document exactly what caused the encounter and what the outcome was. This shows a logical flow of information and …
Neonatal Dilemma – Should You Have Separate Charges for Separate Procedures?
The smallest patients can present the largest and most confusing problems in medical billing. There can often be confusing scenarios that occur during neonatal procedures that many medical billings can find confusing. It could be due to the fact the patient is so tiny that many of the procedures seem related to split out but in many cases, claims for neonatal services are incorrectly bundled together. A good case in point would be if a neonatal patient presented with a fever. The physician then did a urine catheterization (51701) and a spinal tap (62270) in the office. In many cases, the medical biller might have bundled these claims together but …
The Truth About Pediatric PHI
Patient history, or PHI is an aspect of medical billing that has a myth attached. Contrary to popular belief, it is safe practice to allow any permanent office member to take the review of systems and the family social history. These two evaluation and management history elements can actually be taken by absolutely anyone that is employed by the practice. It is ok in medical billing for even a parent or a secretary to take down this information as long as the information is reviewed and signed off on by the acting pediatrician. The only part of an evaluation and management visit that the physician or nurse practitioner must complete …
