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.
Look Twice At Your Bilateral Modifiers
Look Twice At Your Bilateral Modifiers Medical billing bilateral modifiers give billers much headache. Not only are bilateral modifier procedures for medical billing complicated, but they are different for each insurance company. Medical billers must check and double check bilateral modifiers in order to receive payment. It’s true, many payers will not pay claims unless they are in the format in which they require them to be. Unfortunately, each and every payer can have a different medical billing requirement for each and every procedure. Bilateral modifiers are some of the most complicated subjects for medical billers. Modifier 50 is a bilateral modifier. For example, if someone gets eye surgery on …
Can You Use 90784 for ED Injections?
Can You Use 90784 for ED Injections? When performing medical billing for emergency department visits, there are several methods one must follow to ensure full payment. Emergency department injections by a physician and the use of current procedural terminology code 90784 usually brings up many questions. The medical billing question of when to use CPT code 90784 usually becomes an issue when a hospital supplies an injection or antibiotic to a patient. Many medical billers believe 90874 should not be used in this situation because the physician has not actually purchased the drug, just administered. In all actuality, 90784 means- therapeutic, prophylactic, and diagnostic injections; intravenous. It is totally appropriate …
October 2005 Medicare Won’t Honor Paper Claims
October 2005 Medicare Won’t Honor Paper Claims Medicare has big changes for claim medical billing practices! As of October 1, 2005 Medicare will no longer be accepting paper claims or non-compliant electronic claims. If providers do not follow these guidelines, the Centers for Medicare & Medicaid Services will return a claim unprocessed with orders to submit with the correct medical billing guidelines. Take some relief in knowing that this can save your practice money. First of all, paper medical billing claims are not cost effective for your practice. Postage is necessary as well as the cost of paper. Electronic claims don’t have these added costs. Another benefit to electronic medical …
Must A Pediatrician Take A Patient’s History?
Must A Pediatrician Take A Patient’s History? When running a pediatric office there are many questions that come into play with medical billing. It may seem simple for any personnel to ask a few questions and take a patient’s history, but medical billing regulations may actually dictate who is allowed. In all actuality, it is safe practice to allow any office member to take the review of systems and the family social history. These two evaluation and management history elements can actually be taken by absolutely anyone. It is ok in medical billing for a parent or a secretary to take down this information. The only requirement is that it …
How to Recoup Additional Pay With Central Venous Access Codes
Medical Billing Expertise: How to Recoup Additional Pay With CVAs When performing medical billing for central venous access services there are additional ways physicians can recoup more payment. The CPT codes 76937 and 75998 can be used in medical billing to provide extra CVA payment. If a physician performs an ultrasound guided procedure, the code 76937 will give additional money. This code means: ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent real-time ultrasound visualization of vascular needle entry. This means 76937 can be billed separately from the CVA placement code. One thing to note is that this code is only …
Medical Billing Codes 70551-70553
Using Medical Billing Codes 70551-70553 for MRI and IAC Properly There are many times in medical billing when a patient receives both an IAC and brain MRI. The question is, can the medical biller be reimbursed for both of these services separately? If the medical billing personnel asked the American Medical Association this question, the answer would be simple. They would say that you can absolutely get separately reimbursed for an IAC and brain MRI in the same session. Realistically, however, this is not exactly true. The requirement to code for both x-rays is that they need two separate and distinct exams. Each exam is required to have distinct findings. …
Correct Use of Modifier -59 In Your Medical Billing
Correct Use of Modifier -59 In Your Medical Billing Many medical billing require modifiers to justify and explain why a certain service was done or billed. Modifier 59 many times is forgotten or misused. In order to receive correct payment when medically billing, the correct use of modifier 59 necessary. When medically billing, modifier 59 means that a separate service has been performed on the same day as another , but that they are completely separate and should get separate reimbursement. This could mean a different patient visit, surgery, separate lesion, different site, or a completely separate injury. Here is an example of correct medical billing of modifier 59. If …
Documenting E/M On Your Medical Billing
Guidelines for Documenting E/M On Your Medical Billing Evaluation and management services are some of the most common charges medical billing companies charge today. Since evaluation and management claims are so abundant, it is important to methodically document the occurrences. There are several documentation guidelines for E&M that can improve your medical billing accuracy. The first guideline, and possibly them most important, is insuring your ICD-9 codes and CPT codes correctly match with the documentation in the medical records. This may seem obvious. However, there have been many times when medical billing has been performed incorrectly in this manner. Medical records are very important in substantiating procedures and tests billed. …
Medical Billing and EOB
Medical Billing and EOB The goal of any medical billing firm is to receive a correct check and correct explanation of benefits (EOB) from an insurance company. Sometimes this is easier said then done. Many times the EOB goes one place and the check goes another. What is the easiest and most productive method for posting payments for medical billing? The first method is an example of a practice that does their own medical billing. In this case, it is beneficial to make sure a check and EOB are sent to the practice and a duplicate is sent to the patient. This prevents future problems with remainders owed. It also …
How Does a CPT Become a Code?
How Does a CPT Become a Code? Some of the most integral components of medical billing are current procedural terminology codes (CPT codes). In order to understand correct coding practices for medical billing, it is important to understand how a CPT code becomes a code. The first step in issuing a code for CPT comes in the form of a suggestion. Medical personnel, physicians, and state associations regularly make suggestions to the American Medial Association. After a staff member from the AMA reviews the suggestion, that staff member determines if the issue has already been addressed or if it is a new one that needs to be resolved for medical …
