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.
What are NCCI Edits?
If you’re still uncertain what a mutually exclusive edit is and whether you’re using the latest NCCI version in your ob-gyn practice, you could be setting yourself up for future reimbursement hassles. The National Correct Coding Initiative edits are pairs of CPT or HCPCS Level II codes that Medicare (and many private payers) will not reimburse on an individual basis except under exceptional circumstances. Medicare applies the edits to services billed by the same provider for the same beneficiary on the same date of service. Example: The most recent edition of NCCI (version 12.2), effective July 1, includes an edit bundling therapeutic injection code 90772 (Therapeutic, prophylactic or diagnostic injection …
Get Your Inpatient Medical Billing Reimbursed Better
Ob-gyn patients present a lot of unique problems for medical billing. In the case of a pregnancy, the condition usually won’t have a long historical documentation. There isn’t a certain number of inpatient admission days for delivery patients that can be billing globally as each delivery is unique. You did to ascertain if the patient developed complications and also if the ob-gyn is also the treating physician or only making rounds with the patient. You will need to separate out the claim for some carriers accordingly. That will narrow down if you need to bill this claim globally or not. In the case that the patient is not admitted for …
4 Points For Easy Inpatient Billing
One of the most difficult medical billing feats is inpatient consultation coding. There are many instances when a follow-up inpatient consult should be replaced by a subsequent hospital care visit. To eliminate these medical billing errors, there are four facts to consider when coding for inpatient consults. Number one is very obvious. If your report an inpatient consultation exam, the patient must be inpatient, not outpatient. Very often physicians see patients on a consultation basis when they are outpatient. Medical billing mistakes can be made easily. Double check your work. Number two, it is important in medical billing to always report one initial consultation. This code will correspond with the …
Hiring a Medical Billing Consultant?
It’s hard to let go of what you might deem the financial control of your practice. Hiring a medical billing consultant can seem like you’re adding expenses instead of cutting them down, especially if you have never outsourced your billing. If you’ve always discounted outsourcing your medical billing claims because you feel as though you would be relinquishing control over your billing, read on – you’ll find that is not the case. Actually outsourcing your medical billing and coding needs through a consultant is one of the smartest business moves you can make. Don’t think you have to use a local company, many medical billing firms have branch offices in …
The Basics of Outsourcing Your Medical Billing?
If you’re wondering how your medical billing gets to the outsourcing company, the answer is carefully and securely. The patients are seen as usual in your office, your staff creates the records for billing just as they always did. If you are still using paper files your claims will need to be scanned and hand entered into the medical billing system, if you transmit electronically your staff will need to only access the program and transmit the chosen claims to be processed by the medical billing company. The data will be transmitted to the medical billing company who will code and double check your medical billing claims to insure they …
How Private Is Outsourcing Your Medical Billing?
Confidentiality is a big concern in every corner of the medical community. Now that you’ve done your homework, you know outsourcing your medical billing is good for your practice and good for your staff. You know Electronic Claims Filing is the best way to file your medical billing claims, but you have concerns about exactly how private sending your medical billing out of your office to a third party might be. Privacy and security have become major issues for those in the medical profession and for the companies that handle your medical billing and coding. Rest assured, your claims are handled in complete confidence and your patient’s privacy is secured …
Can DME/HME Be a Profitable Venture For Your Practice?
Even two years ago the answer to that question might have been “no”. However, in 2007 it might well worth looking into for your practice. Previously, the cost of the products versus having to track claims, find reimbursements, and keep up with claims status; made DME a very labor intensive venture. With the advent of specialized DME/HME software, secure internet connections, and standardized billing procedures; DME can now be a very profitable venture. In your practice, you will want to be sure that the product(s) you are dispensing are profitable. You need to watch the pricing of the product costs, in some instances, your product costs may be more than …
Avoid Under-Billing Neonatal Services
Under-reporting medical billing claims is unfortunately common and it costs revenue as you’re not being fully reimbursed for services rendered. Learning the exceptions to the bundles will allow you to break out services that can be billed alone – once you start investigating neonatal services you’ll realize quickly that you may have very been missing legitimate reimbursements. A scenario that isn’t uncommon is when a doctor attends a delivery of a 28-week gestation baby. The infant received positive pressure ventilation (PPV) in the delivery room (DR) with mask and bag for absent respiratory effort at birth. The baby was then intubated in the delivery room and received PPV on transfer …
Keeping Up With Medical Billing Changes
January 2007 brought more changes to the medical billing industry. Certain codes were “retired”, new codes were added and others simply had their meanings broadened to encompass their meanings. If your practice doesn’t keep up with the changes and know in advance of coming changes, you can be losing out on legitimate revenue for services rendered. Some practices are losing up to one fourth of their revenue simply because they staff isn’t aware of the best techniques for reporting procedures. Undercoding is another way many practices don’t get the full value for their services. If your staff is undercoding your medical billing claims you are definitely missing out on reimbursements. …
Critical Care NCCI Edits For 2007
NCCI has some important updates for 2007, If you need to report an emergency department (ED) visit as well as a critical care code (99291), you should keep in mind that a bundle, care of the National Correct Coding Initiative (NCCI), version 12.3, prevents you from reporting both. The code range that you should be aware of is 99281-99285 alongside critical care code 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes). The ED visit is now a component to the comprehensive critical care service with the new NCCI edit, you can’t separate this with a modifier. There are currently no known …
