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.
Medical Billing Questions – Is Oxygen a Separate Code?
If you’re having trouble finding an oxygen administration coding in the CPT, the reason is that there is no specific oxygen administration codings for your medical billing. When a patient requires oxygen, the use of the oxygen is bundled into the day’s EM services. When a doctor prescribes the oxygen, you should use the appropriate office visit code that describes the procedure and services performed by the physicians that necessitates the need for oxygen. Full documentation of the medical billing claim will insure that your bundled oxygen administrations codings get full reimbursement. For example, if you have a physician who performs a detailed examination and incurs moderate complexity decision making …
Incorrect Medical Coding Can Cost You
Incorrect coding of your medical billing claims is the number one reason for loss of revenue in most practices. Simply put, if you’re not coding correctly, you’re losing money. Sometimes your medical billing claims will be partially paid, other times they will be completely denied. This causes lost time because your staff will need to go back, pull the file, verify what procedure was done, look up the code to make sure it hasn’t change and refile and resubmit the claim. When you consider on the average about 30% of paper claims are denied or kicked back for errors, throw in the fact sometimes medical billing codes can change 4 …
New Coding For Educational Services
You may already be tearing your hair out trying to keep up with the ever-changing CPT codings and relearning the newly changed codes on your superbill. There were also 3 low-key series additions that describe educational services that you may provide. Education and Training For Patient Self Management includes the following codes: * 98960–Education and training for patient self-management by a qualified, nonphysician healthcare professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient. * 98961–… 2-4 patients * 98962–… 5-8 patients. Reserve Self-Management for Non-MD Education is another set that was added and includes the range of codes from (96150-96155). Only non-physicians …
Medical Billing Dilemma – Reporting Two Codes
When a laparoscopic procedure is performed, it may seem like it should be reported separately from the open procedure, however at this time, most carriers and that includes Medicare will only pay for one open procedure no matter how much work the surgeon does laparoscopically beforehand. With very rare exception, you should report the open procedure only as using the laparoscopic code may result in your medical billing claimed being deemed over coded and will be rejected. Another rule of thumb to know when reporting this type of procedure is when an endoscopic procedure is attempted and fails on the patient and then another surgical service is rendered, only the …
Looking Ahead to the 2007 Physician Fee Schedule
CMS has released a preview of its payment adjustments for physicians in 2007 and in the preview ,there are even more cuts in Part B reimbursement. CMS projects a 4.6 percent cut to the 2007 Physician Fee Schedule, and explaining this is due to an almost 9 percent increase in spending as a large contributing factor to this decision. On the list of spending increases that was released by CMS, the minor procedures category is listed as one of the fastest growing areas with the highest number of claims being in the fields of podiatry and dermatology. Of the 9 procedures that accounted for the largest spending growth, the following …
Changes in Maryland Medical Billing for Medicare
If you are a physician located in Maryland, be aware that as of April, Medicare is now approving a broader coverage for the use of home oxygen for individuals that are enrolled in a federally approved clinical trial that is sponsored by the National Heart, Lung and Blood Institute. Under the current Medicare statutes, Medicare only pays benefits for individuals that have a partial pressure measurement at or below 55mmHg or an oxygen saturation that measures in at or below 88 percent. If another disease or medical condition is present, Medicare will provide benefits if the partial pressure and oxygen saturation are raised one percent. So partial pressure would begin …
Correct Coding=Ob-Gyn Medical Billing Claims Paid
Recent studies showed a large number of errors in the medical billing claims submitted for patients suffering from eclampsia and preeclampsia. Because multiple procedures are common with ob-gyn patients, billing errors happen frequently. The number one reason for coding error is usually due to a physician being rushed and missing a procedure that should have been billed. Most staff in a physician’s office are trained to handle patients, not make sure each and every line on a medical billing form is filled in correctly and with a logical flow of services. This means many doctors are not receiving the maximum reimbursements for the services they perform for their patients and …
Medicare-No Pay For Certain Gastric Procedures
If you are a physician that does regular gastric by-pass procedures, you need to know that as of March 17th, Medicare will no longer reimburse the code 37216 which is transcatheter placement of intracatheter stents according to their latest transmittal from the Centers for Medicare & Medicaid Services. Other changes that are coming soon will be to the physician reimbursement fee schedule. New medical billing claims need to show code 37216 to have the status code of “R,” and carriers should adjust their systems to “reflect a non-coverage status” for this particular code. Another change in the gastric medical billing category will be to restrictive procedure code 43842 that will …
Watch Your Usage of Sedation Codes In Medical Billing
In the new 2006 release, CPT introduced six new codes for moderate sedation (99143-99150, Moderate (conscious) sedation) and the six new codes replaced the two previously used conscious sedation codes (99141-99142). For the moment, the six new codes have been assigned by Medicare a status of “C”, which means that the codes are carrier priced. In many instances carrier priced often means no reimbursement for the physician. Certain Medicaid programs will pay for moderate sedation for children. For example, if a child comes in with a high fever and the doctor suspects an illness like meningitis, the doctor may need to give the patient a spinal tap under moderate sedation …
Combining History with Illness In Your Medical Billing
Combining history of present illness and review of systems is possible when doing medical billing. Many medical billers think this practice is breaking a rule or impossible. However, documenting an element once to account for HPI and ROS is perfectly legal when done correctly. The CMS states that physicians absolutely do not need to document an element two times just so the person performing medical billing knows it is meant to be used both for review of systems and history of present illness. It is perfectly acceptable to use an element for both. The only time an element cannot be used twice is when you attempt to use it in …
