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.
Always Appeal Your Denied Medical Billing Claim
It is a well known fact that everyone is human and we are all prone to make mistakes from time to time. Often times, your medical billing personnel could end up miscoding an item just because they are not up on all of the latest rules regarding ICD-9-CM or CPT rules. Because of the chances for a miscoded item being so high, it is always important that you know how an appeal can help you when your medical billing claims get denied. You may already know this, but there are a good deal of practices that will actually lose a good deal of money every single year because they do …
Double Check Those Medical Billing Adjustments!
Your staff may be grumbling about the M0175 medical billing adjustments. The Centers for Medicare & Medicaid Services announced that all home health intermediaries are required to post their adjustments however the new adjustments were delayed in posting to the United Government web site and the CMS delayed the implementation of the adjustments. Your medical billing staff needs to check the website frequently to make sure you’re getting all the adjustments that are due, if you miss filing on an adjustment, you are literally throwing away money. If your in-house staff is overworked and having a hard time keeping up with the changes, new codes, deleted codes and the filing …
PHI – Is Yours Safe?
Billing and reimbursements are the life’s blood of any practice. They keep the offices up and running. Without proper claims submissions and payments, there would be no money to run the practice. PHI is a big element when submitting claims. Keeping PHI safe is important for your patients’ safety and the longevity of your practice. PHI information is confidential information that only your patient, you, and covered entities should have access to. This medical billing PHI would include a patient’s social security number, diagnosis, treatment plan, medical history, and other personal and pertinent information. Since the content of your medical billing claims is so sensitive, it is important to always …
Correctly Using POS Codes in Your Medical Billing
More and more carriers are cracking down on medical billing claims that have a lack of or incorrect place of service code. Even with the correct current procedural terminology code for E/M services, a medical billing claim that does not have a correct POS code will get your claim denied. It is a common occurrence in medical billing for the place of service codes to be misused or left out. 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 …
Magical Modifier 25
Modifier 25 is a medical billing code used to indicate extra work for a medical service or procedure. There are three simple steps you can use to learn how to correctly use the medical billing modifier 25. The first medical billing step to correctly use modifier 25 is to only report the most significant services provided during the visit. When reporting an Evaluation and Management exam, it is very difficult to perform a service that is separately billable. Most things are covered under the evaluation and management, including injections and tests. In order to correctly append the medical billing modifier to a procedure, it must be very significant. The next …
Proper Usage of Code 58679
Even with the reams of information and thousands of codes, there are many procedures in which there is no particular medical billing code to represent it. For instance, an Oophoropexy is usually performed for radiation therapy, but what if it were part of a treatment for polycentric ovarian syndrome? In the oophoropexy example above, some medical billing staff members may use the current procedural terminology code 58825 (Transposition, ovary). Unfortunately, they would be incorrect and would receive most likely a very reduced reimbursement or an outright denial of the medical billing claim. The definition of transposition is when an ovary is moved due to radiation therapy. Since radiation therapy is …
Thinking about a Career in Medical Billing?
Doctors are very busy these days treating patients in their offices, attending to surgeries, making their hospital rounds and answering important phone calls. They simply do not have the time to attend to the financial aspects of running a medical practice. Aside from nurses, receptionists, physician’s assistants and technicians every well-trained staff has at its core key people specifically designated to medical coding and billing. It shouldn’t be a surprise that there is an explosion of career opportunities in medical coding and billing. Estimates chart the growth of medical billing and coding careers at over 65% within the year 2005. This surging demand for specialists in this area accounts for …
If You’re Considering Hiring a Medical Billing Consultant
Physicians who need help managing billing in their offices may want to consider a company that specializes in medical billing consulting. Medical billing services help doctors get paid from insurance companies. But medical billing consultants often go a step further, and help doctors manage all their finances, from billing, to accounts receivable, to collections. Some medical billing consulting services work on-site as part of the practice management team. Others work off-site and only come into the office as needed to analyze what needs to be done. Many help to train employees to better handle billing, coding and reimbursement issues. They may also help to analyze workflow in doctors’ offices, to …
Medical Billing a Healthy Part of Modern Medicine
Medical billing is the practical management aspect of medicine and the way the healthcare provider gets paid. Without a good medical billing and coding foundation to base the billing of a practice on, the practice will cease to exist from lack of revenue. In legalese, the “face-to-face contact between healthcare professional and an eligible beneficiary” is known as “an encounter.” For every such “encounter,” there is a specific code. These codes exist for the sole purpose of identifying for the payer what they are paying for. The services rendered codes (CPT) must match the diagnosis code (ICD) for the payment to be deemed necessary and just. CPT medical coding books …
Reasons to Outsource Your Medical Billing
In a busy practice, the attending physicians have no time to compile their own medical billing. Keeping up the with lightening fast coding changes is hard enough without keeping up with the necessary documentation, making judgment calls on complex issues and then coding and compiling a superbill for each and every patient seen. This sounds overwhelming and time consuming and in the early days of many a practice, many physicians did do their own medical billing. Good practices grow and soon the doctor had hired someone to take care of paperwork and submission of all their medical billing claims. This person is usually called a PA or physician assistants. It …
