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
When You Can Discard Modifier 25
Modifier 25 cuts a fine line in the medical billing world. Auditors tend to target medical billing claims with this modifier however CMS recently clarified again that they do indeed want this modifier used where appropriate in medical billing claims. The best rule for when to use modifier 25 is met when your physician provides a significant and separately identifiable E/M service on the same day as a procedure with a global period. If your services meet that requirement, you are free to use the modifier without worry in your medical billing claims. The CMS updated the usage language of the modifier in the release on August 20, 2006 and …
Medical Billing Dilemma – Medial Dislocation
A common occurrence in the emergency is the dislocation of various joints. They are sometimes incorrectly handled as breaks but shouldn’t be and you could be setting your practice up for a denial at best and audit at worst if you report these procedures incorrectly on your medical billing. Even if the reduction of the dislocation fails, the attempt should be reported on not only the medical billing as a procedure but also in the documentation as another procedure will have to be tried to relocate the elbow to its proper placement and you can show the timeline for the necessity of other and more involved treatments. On the claim …
Medical Billing Watch – CMS Watching Radiologist Billing
A two year study by Medicare showed that Radiology providers billed Medicare inappropriately for a staggering 100,034 radiology services according to HHS Office of Inspector General (OIG). This translated into Medicare overpayments to the tune of $20 million dollars where Medicare Part A covered radiology services but providers still billed Part B for the technical component of those services as if they were outpatient services according to the OIG report. In a nutshell, Medicare paid these claims twice. Prepayment edits are the proposed solution to this matter and would disallow the submission of any medical billing claim that had the same services under Part A and Part B claims. If …
The Upcoming Changes to Power Mobility Devices are Clarified by CMS
Power mobility devices (PMD) have become a very big business and also given patients a new lease on life by being able to get around in an easier fashion. Previous reports had stated Medicare would no longer pay for PMD devices, however Medicare will still pay for a Group 2 power mobility device (PMD) when appropriate according to a memo released by the Centers for Medicare and Medicaid Services. A fact sheet released by CMS on Sept. 20 clarifies this as saying many facilities misinterpreted that medical billing claims for PMD devices would not be paid, however that is not correct. When the new statues went into effect on October …
Will Outsourcing Your Medical Billing Get Your Claims Paid Faster?
You bet it will. Outsourcing your medical billing is a big decision but it is also a very smart one. You are not only freeing up your staff to help run your busy practice, you are allowing the professionals whose sole business is to keep up with the fast paced and ever changing coding and regulation changes in our industry, take care of all of your billing and coding needs. You have a busy practice, your staff is busy servicing patients and generally doesn’t have the free time to devote to seeing what claims were paid and only partially paid. Your medical billing outsourcing partner has the knowledge, experience and …
