Medical Billing Blog with Medical Billing & Coding Info & Articles
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Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding, ICD, HIPAA and practice management functions.
2004-2024 Celebrating 20 Years of Healthcare RCM Articles
The Blog Currently Contains 1,265+ Healthcare Articles
How Depth Affects Excision Claims
Depth is very important when choosing the appropriate code for coding excision claims. For example, a surgeon excises a lipoma from a patient’s back, and the excision measures 5.0 cm x 4.0 cm x 2.0 cm. In this situation, should you select code 21930 or code 11406 for the procedure that was performed? The key to deciding which code is the correct code is the depth of the excision that the physician performed on the patient. Assuming that the depth, in this example, is 2.0 cm (20mm), is much greater than the average thickness of the skin (2-3mm), so you are justified to report code 21930 (which is excision, tumor, …
2 Code Claims Complex Closures on Excision Claims
When closures become complicated, it is possible to have a two code claim. If the ED physician removes a lesion, he or she will also need to close the site prior to releasing the patient to go home. If the closure is a simple repair, then the work is combined into the lesion excision code. If the repair is more complicated then that though, then you can report the closure separately. If an intermediate closure is performed by the ED physician, then you will choose a code from the 12031 – 12057 set, but for complex closures, then you will choose a code from the 13100 – 13153 set. These …
Medial Dislocation – Billing it Right
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 …
Ready for the New NCCI Edits Coming in July 2007?
The new edits coming in July 2007 will mainly affect ER room practicioners and physicians and nurses that treat patients in nursing home facilities. These updates will be items you need to know in order to avoid denials and get maximum reimbursements on your medical billing claims. The codes that were changed in the upcoming release were codes 99281-99285 (Emergency department services) are considered component codes of the more global 99304-99306 codes (Initial nursing facility care). This means if a single physician provides a level-two ED service along with a level-two initial nursing home service, you should only report 99305 (Initial nursing facility care, per day, for the evaluation and …
Reimbursements Can Be a Reality For Chronic Bronchitis Claims
If your medical billing claims for patients who present and are diagnosed with chronic bronchitis are getting denied payment by the carrier; take a very close look at the code you’re using to report this condition. One of the biggest reasons chronic bronchitis isn’t paid on a claim is because it is reported as a general chronic code using 491.9, Unspecified chronic bronchitis. The trick is to forego choosing the 491.9 as the ICD-9 will lead you to do. Instead look for the diagnosis of the possible cause of the chronic bronchitis such as chronic asthma which has its own specific code. If procedures were performed on the patient, note …
