Medical Billing Blog with Medical Billing & Coding Info & Articles
Welcome to the Medical Billing and Coding Blog
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
Caution When Using Modifier 59 in 2007
Modifiers can be a helpful addition to medical billing. However, there are certain modifiers that are constantly used incorrectly. The contractors for the Centers for Medicare and Medicaid Services are now keeping an eye out for suspicious modifiers. The medical billing modifier 59 is on the list of modifiers to flag for review. Recently, the U.S. Office of Inspector General released a report that showed some daunting medical billing news. Modifier 59 has been the cause of over $59 million in overpayments to nursing homes and providers. Due this large number of overpayments, Medicare contractors will be closely scrutinizing each medical billing submission that contains the modifier 59. Another medical …
Medical Billing Tips for Cardiac Rehab in 2007
Cardiac rehabilitation staff members have great medical billing news coming their way. The Centers for Medicare and Medicaid Services expanded coverage for cardiac rehab. The medical billing element for cardiac rehabilitation will be much less strict when it comes to requirements. In the past year, the requirements in order to get medical billing reimbursement for cardiac rehab were strict. You had to have a heart attack, angina, or coronary artery bypass surgery. The Centers for Medicare and Medicaid Services now realizes that this type of care does not prevent any problem from occurring. It was merely reactive treatment. In December of 2005, the Centers for Medicare and Medicaid Services announced …
Medical Billing for Auditory Rehabilitation
Medical billing in the speech, language, and hearing community is looking a little brighter, medical billing reimbursement will be nearly four times the old amount for this code.There was a dramatic increase in the amount in 2006, however many practices are not taking advantage of this increase. The current procedural terminology code 92626 (Evaluation of auditory rehabilitation status; first hour) was reimbursable at $22.07. This has changed. Medical billing now allows this code to be valued at $81.76. The relative value unit (RVU) used to calculate this medical billing reimbursement was 2.20. Originally the RVU was 0.55. The American Speech Language Hearing Association (ASHA) was the reason the RVU was …
How Can An Outside Audit Help Your Practice?
No one likes the word “audit” but sometimes it can help your practice. When it’s coming from the IRS or other authority office, an audit can be a major stressor; when you enlist the services of a third party partner to do an audit on the way your medical billing is filed – there are no penalties – only pluses! An internal audit of the way your medical coding and billing is handled can alert you to problems you may not have even been aware existed. Staff members can be adverse to change and continue using coding combinations that do not result in the maximum reimbursement for your services. When …
Why Medical Billing Claims Get Denied?
There are a number of reasons that your medical billing claims could be getting kicked back. Next time you have a medical billing claim kicked back, carefully check it to see why it was returned. Finding out why your medical billing claims were refused will sometimes uncover an unhealthy pattern in your office such as not keeping up with the changes to the CPT codes. And that’s our number one reason, usage of outdated or improper codes. The CPT updates a number of times a year and keeping up with those changes can be difficult. However, if you don’t use the most current coding the carriers are well within their …
