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.
Medicare Medical Billing Error Decrease
Medicare has released the stats for 2005 regarding The Comprehensive Error Rate Testing (CERT) program implemented last year and it is showing that in the initial stages it has done some good for medical billing. The Centers for Medicare & Medicaid Services heightened claim error awareness by initializing an error-testing program in 2005. In 2004, the error rate for medical billing was 10.1%. At the end of 2005, this year’s CMS error rate was 5.1%. This is nearly half the amount of errors this year than last year. The Centers for Medicare & Medicaid Services attribute this improvement to the new CERT program. They believe that providers are inherently more …
Documentation is the Key to Getting Reimbursed
There are two major medical billing elements for critical care patients. If these two elements are missing, no or partial reimbursement will be received. In order to collect all the money you are entitled to, your medical billing must be accurate. The two most important elements in medical billing for critical care are time services were rendered and medical necessity requirements. Let’s face it, during emergency situations documenting times of services rendered on a patient is not the most important factor when dealing with a critical care patient. Patients are quickly moved into the emergency room, are quickly examined and treated as fast as possible. There are two main critical …
Get Correctly Reimbursed For Your Discography
There are many different rules about bundling your medical billing claims. Some codes are included with others, while different codes can be separately reimbursed. A discography is a procedure that brings up a lot of questions. In medical billing, the question about whether or not to code per region or per disc. This is one instance in which you may get more reimbursement than expected. The AMA (American Medical Association) states that you can report per disk when doing medical billing for a diagnostic discography. The code 72295 (Discography, lumbar, radiological supervision and interpretation) should be billed for as many disks as you treat. Even if the discography is only …
Continuous Care Medical Billing Claims Paid
If you have medical billing claims that include continuous care claims, be sure to meet the minimum requirements or your medical billing claim could get held up under review or worse – outright rejected. There has been a significant increase in the past 5 years of continuous care claims and those types of medical billing claims are being looked at on a closer level than ever before. The growth is legitimate as Americans are living to older ages than ever before. Watch the usage of modifiers when you’re billing for long-term care claims. There can be some issues raised with your claim if you use a modifier that does not …
Are You Still Using Confirmatory Consult 99271?
If you’re seeing denials of your medical billing claims for confirmatory consultation and you aren’t sure why it is occurring, the Current Procedural Terminology codes were eliminated in January 2006. This change affected the way many treatments were approached and the amounts that practices will be reimbursed. A confirmatory consult in medical billing is defined as a visit where one physician confirms the opinion of another physician. The current procedural terminology codes used are 99271-99275 (Confirmatory consultation for a new or established patient) for a confirmatory consult. This code range is now defunct. There are now two options in medical billing for coding a confirmatory consult. You should either report …
Proper Reporting for Medical Billing of Twins Delivery
If you have a medical billing claim to process that includes twins delivery and one was a traditional birth and the other a cesarean, you should report two codes. If both babies were delivered traditionally (vaginally), report only one code for both babies, as it will be considered one procedure. If there are no complications, the babies will both be born vaginally. You should report 59400 (Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) for the first baby and 59409-51 (Vaginal delivery only [with or without episiotomy and/or forceps]; multiple procedures) for the second baby. Your diagnosis code will be 651.01 …
Special Medical Billing Dilemma
With multiple births becoming more and more commonplace, the reporting of twins on medical billing claims has become more routine and there are some special considerations when filing out your medical billing claims. If both babies are born by cesarean, bill only once. Remember, the doctor delivers all of the babies–whether twins, triplets, or more–by cesarean, you should submit 59510-22. Report 59510 with modifier 22 (Unusual procedural services) appended, because even though only one incision was made, the modifier will testify to the fact that multiple babies were delivered. Be sure and include your medical documentation as to the reason for the necessity of the cesarean. If the babies were …
Reasons to Outsource Your Medical Billing Functions
If you’ve been feeling the stress and strain of too much paperwork and time spent preparing medical billing for your practice and not enough time is left to service your patients to help your practice grow, it might be time to consider outsourcing your medical billing claims. There are some sobering facts about medical billing claims that might give you pause to consider it might be time to outsource your medical billing. When you consider that healthcare providers averaged spending $7 billion annually just submitting claims to carriers. Another jaw dropping fact about your medical billing claims, is you might be missing being reimbursed for nearly 1/3 of your legitimate …
Medical Billing for Nutritional Counseling
With obesity among patients rising at an alarming rate, the continuing counseling of patients who need nutritional information, especially for controlling their diabetic conditions is also on the rise and it is fast becoming a common coding in medical billing. If it can be reimbursed and how it can be reimbursed are two dilemmas that many physicians are finding confusing. If you’re not getting reimbursed for your patient counseling, you’re losing money for your practice. When an individual nutritionist consults with a patient in a non-certified physician setting, you’ll most likely report sessions with 97802-97804. But if your practice has an American Diabetes Association-approved program, you may also use Medicare-specific …
Getting New Patient Office Visits Paid by Medicare
If a new patient presents in your office and it is determined through evaluation that a pap smear is necessary – Medicare will probably deny the claim unless you can show medical necessity of the preventative measure. You will need to use pap and a pelvic code with 99203 is if the patient presents with a problem that needs to be evaluated. Using code 99203 (Office visit) is not a substitute for the rest of a preventive exam (which Medicare generally does not cover). Use modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the …
