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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.

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What About Modifier Q6?

Remember when medical billing used to be a simple affair of matching the procedure done with a couple of medical billing codes to describe what was done, attaching your documentation and then submitting your medical billing claim for reimbursement? Now we have codes for codes and modifiers and the need to when to bundle and when to not bundle with the goal being fair reimbursement for procedures done. Modifiers cause a lot of confusion for many medical billers. One such confusing modifier that is worth clarifying is Q6. This applies to Medicare medical billing claims only, but in a nutshell when one of your staff physicians takes a leave of

Published By: Melissa Clark, CCS-P on January 4, 2007

Correct Coding for Long Term Care Medical Billing Claims

Long term care medical billing has it’s own set of nuances that must be followed in order to ensure that you receive proper reimbursements for the services you provide. Since nearly every patient you treat will have a long term history of care – it’s sometimes tempting to skimp on the medical documentation and necessity but since you have no way of knowing who is going to review your claim, you need to handle every claim as a fully individual manner complete with full documentation or you may wind up with partially paid claims or outright denials of your medical billing claims. One important thing to learn is when you

Published By: Melissa Clark, CCS-P on January 3, 2007

Make the Switch to Outsourcing for 2007

Outsourcing your medical billing claims to a third party partner may be one of the smartest business moves you make in 2007. You may have had every intention of doing your own medical billing for your practice from the day you opened until the day you retired, however with the never ending changes and nuances in medical billing claims varying from cancelled codes to nonpayment of certain procedures because they simply weren’t reported correctly – there comes a time when you need to look at your revenue flow from your reimbursements and decide it might be time to outsource your medical billing claims. Another reason to outsource is the small

Published By: Melissa Clark, CCS-P on January 2, 2007

Sure Fire Reimbursement Techniques On Your FBR Medical Billing Claims

When you’re reporting a medical billing claim for foreign body removal (FBR) from the eye on many occasions you may not be getting the full reimbursement that is due because you might be missing something extra. A good example is if a patient presents to the ED with a foreign body in her left eye. The ED physician performs a removal of the foreign body and uses a slit lamp in the procedure. A level three evaluation was also performed to check for additional injury caused by the presence of the foreign body. In most cases, you’ll be able to report a pair of CPT codes. One for the ED

Published By: Melissa Clark, CCS-P on January 2, 2007

A Good Solution for Colonoscopy Confusion

There has been growing confusion over exactly how to report the growing number of colonoscopies that become “diagnostic”. This procedure has become more and more commonplace and the debate continues. Sometimes the best answer is the most obvious, contact the carrier and ask them how they want the procedure reported on your medical billing. Colonoscopies are part of a check up for most individuals over the age of 50, however when the colonscopy finds a polyp, you should normally use the polyp diagnosis in your medical billing claim and not the screening V code. The exception to this rule would be if the physician discovers a polyp during the screening,

Published By: Melissa Clark, CCS-P on December 29, 2006