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Are You Getting Maximum Reimbursements for ER Dislocation Procedures?

A common occurrence in the emergency is the dislocation of various joints. They are sometimes incorrectly handled as breaks but shouldn’t be and you could be setting your practice up for a denial at best and audit at worst if you report these procedures incorrectly on your medical billing. Even if the reduction of the dislocation fails, the attempt should be reported on not only the medical billing as a procedure but also in the documentation as another procedure will have to be tried to relocate the elbow to its proper placement and you can show the timeline for the necessity of other and more involved treatments. On the claim

Published By: Melissa Clark, CCS-P on October 12, 2007

Getting Place of Service (POS) Codes Right

For correct payment amount, accurate place of service codes are required. The failure to provide the correct place of service code with the correct current procedural terminology code for E/M services will cause your claim to get denied. One of the most important elements of medical billing is the place of service code. In medical billing, the place of service codes for an evaluation and management are commonly misused. There are several current procedural terminology codes for an evaluation and management session that correspond to different medical billing place of service codes. When using CPT 99341 (Home visit for the evaluation and management of a new patient) through 99350 (which

Published By: Melissa Clark, CCS-P on October 11, 2007

HIPAA Clarifications Coming for Mental Health Workers

If you work in the mental health area, you can expect there to be a coming clarification on how HIPAA and FERPA should be interpreted along with a other state and federal privacy laws dealing mostly with situations concerning mental health workers when dealing with patients in conjunction with educations and law enforcement. This change is largely in part to the misinterpretations of privacy laws that were contributed to the Virginia Tech shootings earlier this spring, however it was not attributed to the laws themselves, concluded federal officials in a report to the President. The report was a compilation of data that was put together by several different agencies including

Published By: Melissa Clark, CCS-P on October 10, 2007

Medical Billing Dilemma: Adjustment of Gastric Band

Sometimes after a gastric band procedure, the band may slip during healing and need to be adjusted. The uncertain thing is how to bill the procedure since you have already billed the global. HCPCS temporary code S2083 (Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline) or CPT code 43771 but both of these require that the physician use a laparoscope during the procedure and usually moving the band is done through injecting saline or removing saline from the band to make it easier to adjust through a subQ port. For most instances you can use S2083, normally you will only use 43771 if patient

Published By: Melissa Clark, CCS-P on October 2, 2007

Break Out Well-Woman-Care Visits For Better Reimbursements

A little known fact about well-woman care is that in many cases, you can break out the breast exam and pap smear and realize a reimbursement for both procedures if the patient is covered by Medicare. If the physician provides a complete well-woman exam for a Medicare patient, you should report G0101 (Cervical or vaginal cancer screening; pelvic and clinical breast examination) for the breast and pelvic exams. When the physician also obtains a Pap smear, use Q0091 (Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory)and this will enable your practice to realize a reimbursement for both services. Just make sure that you have

Published By: Melissa Clark, CCS-P on September 29, 2007