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.
Separate Charges for Separate Procedures
Neonatal patients seem to present confusing scenarios for many medical billers. 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 that would be incorrect as they are two distinctly different procedures even though they were performed at the same visit. Also, …
Thinking About Outsourcing Your Medical Billing?
Outsourcing has become a dirty word in many industries due to the substandard nature of the work that is produced in many niche markets. However, with a little due diligence and making a smart choice with the company that you choose to partner with for your medical billing – it can be a rewarding experience for your practice. A medical billing partner like Outsource Management Group can not only process your medical billing, they also have practice management services that can help you keep tabs on your accounts receivable so you have a steady influx of revenue at all times. Another great feature of outsourcing is that OMG can get …
Are You Properly Handling PHI?
In medical billing, PHI is personal patient information that should only be shared with covered entities. It is not only unethical to release a patient’s medical billing PHI to outside sources but it can ruin your business as well. An example of wrongly shared PHI is at the University of Missouri Health Care. Currently over 800 patients have a class-action lawsuit filed against them. The patients claim their confidential medical billing records were released to a home health provider called Option Care. Option Care apparently used the information and contacted the patients trying to sell them pricey medications. They also tried to convince them that their doctor, Dr. Paul King, …
Rejected Claims Hurt Revenue
In the fast paced world of medical billing, it can be difficult for your staff to keep up with not only a busy practice, patient phone calls, needs that crop up and then the medical billing too. If a member of your staff misses a line item on your medical billing or uses an out of date code, it can directly affect your revenue in the form of a claim that isn’t fully paid or worse a rejected item that requires your staff to pull the file, review the documentation and then resubmit the claim to the carrier. This takes valuable time away from your practice and has your staff …
You’re Coding Modifier 59 Correctly With These Tips
Using a modifier incorrectly can cost you in terms of reimbursements and time. Carriers are closely scrutinizing medical billing claims for incorrect usage of modified 59. There are two main areas that you can concentrate on to avoid getting his with denials or pay backs and insure that you use the modifier correctly. A study of the OIG found a 40% error rate for modifier 59 and you can double check your billing. First of all, in order to use modifier 59 there must be services performed at separate regions. Fifteen percent of the OIG’s audited claims using modifier 59 had procedures that weren’t distinct because “they were performed at …
Avoid Reductions By Properly Reporting Modifier 52
Avoid Fee Reductions By Reporting Modifier 52 Properly If it has become a habit to append modifier 52 every time your medical billing has a service that doesn’t exactly meet a CPT code description, you could be unknowingly cutting your compensation on your submitted claims. AMA CPT guidelines state that modifier 52 should be used when the physician partially reduces or eliminates a service or procedure at his own discretion. The CMS guide lines state as follows: “when a procedure/service performed is significantly less than usually required”. What you should do is report the code as usual for the procedure and then append modifier 52 to show that the services …
Oh No! Medicare Computer Glitch!
The software switch is over at Medicare, but keep your eyes peeled for medical billing mistakes coming from the Centers for Medicare & Medicaid Services. Medicare Part B carriers have switched software systems over to a new billing software that is part of a multi-carrier system. Some carriers have already switched to the system, some are in the process of switching and some will change in the near future, many providers are implementing this switch in January 2007. During the Centers for Medicare & Medicaid Services software switch, there were many medical billing claim errors. Errors that have occurred or could possibly occur again in the future include: missing updated …
Critical Care Evaluation and Management Reimbursements Made Easy
Pediatrics 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 critically ill or critically injured patient; first 30-74 minutes. You would …
Are Your Arteriogram Claims Getting Paid?
This article will make you a bilateral renal arteriogram medical billing pro. There are many code confusions with this increasingly common surgical procedure. Some payers will not pay a cent if you submit your medical billing with the wrong code combinations. However, doing medical billing for renal arteriograms can be quite simple. There are two codes one should report when doing medical billing for a renal bilateral arteriogram. The current procedural terminology code 36245 should be reported twice. Then the Current Procedural Terminology code 75724-26 should be reported. Do not make the mistake in adding a G0275 to your claim because the renal arteriography already includes that service. If you …
Proper Reporting for Varicose Vein Repair
Varicose vein treatments are becoming more and more frequent as more patients are urged to get them treated to stave off the possibility of blood clots and other issues that can crop up later if they are left unaddressed by the patient. However reporting the varicose vein treatment procedure on the medical billing may be a little confusion for some; once you know the basics for setting it up – it’s easy! A good example would be if a patient with varicose veins in her left lower leg presents to the ED and is stating she has severe pain in her leg. One of the veins is clearly bleeding so …
