Medical Billing Blog: Section - Paper Trail

Archive of all Articles in the Paper Trail Section

This is the archive containing links to all articles written in the Paper Trail section of our blog.

Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.

Outsourcing a Dirty Word toYou?

The word “outsourcing” has become a dirty word for many physicians that have been burned by medical billing companies that either outsourced their claims to medical billing companies that use neither secure networks nor adhere to HIPAA regulation in order to maximize their profits; or the outsourcing company just turned out to not be reliable and it wound up costing the practice money to utilize their services. Don’t let a bad experience keep you from partnering with a legitimate medical billing company that can not only help you get your reimbursements faster but also realize great profits by maximizing every single medical billing claim that is filed to make sure

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Getting Place of Service (POS) Codes Right

For correct payment amount, accurate place of service codes are required. The failure to provide the correct place of service code with the correct current procedural terminology code for E/M services will cause your claim to get denied. One of the most important elements of medical billing is the place of service code. In medical billing, the place of service codes for an evaluation and management are commonly misused. There are several current procedural terminology codes for an evaluation and management session that correspond to different medical billing place of service codes. When using CPT 99341 (Home visit for the evaluation and management of a new patient) through 99350 (which

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ICD-9 Updates Coming October 1, 2007

Are you ready for the updates coming on October 1? There are a number of changes that will affect that way Medicare reimburses your practice for the services rendered as well as adding and retiring other codings. All of these changes will be effective for service dates after October 1. You can avoid a lot of paperwork hassles and denials by making the jump to outsourcing your medical billing. Your third party partner will keep up with the ICD-9 coding changes, rules and regulations and if you choose, can even do an audit of your current medical billing methods and show you how you can realize a better reimbursement rate

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Aural Rehab Not Reimbursed?

Medical billing changes occur throughout each and every year and keeping up with those changes can be confusing. Aural Rehabilitation has become one major area of confusion since the 2006 update. The medical billing changes to Aural Rehab CPT codes has wrongly caused many people to believe Aural Rehabilitation is no longer a reimbursable service. Medicare actually assigned status code “I” to all new medical billing codes for auditory rehabilitation. These codes are 92630 and 92633. This means that the Centers for Medicare and Medicaid Services will not pay for auditory rehabilitation, only diagnostic audiology. However, this is only true if an audiologist performs the service and the medical billing.

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Coding Chronic Pain Syndrome

“Chronic pain syndrome” can be considered as a vague description of a vague diagnosis by your carrier and unless you back up your medical billing with the reasons for using this catchall term for several pain conditions, you may be seeing only partial reimbursements to denials for this condition. Traditionally, ICD-9 directs you to code 338.4 (Chronic pain syndrome) for the condition. However, you may need to couple this diagnosis with other probable causes backed up by symptoms and doctor’s notes. Other diagnosis possibilities for chronic pain syndrome include fibromyalgia/muscular pain (729.1, Myalgia and myositis, unspecified); reflex sympathetic dystrophy/regional pain syndrome (337.2x, Reflex sympathetic dystrophy) or peripheral neuropathy (337.0, Idiopathic

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Been Hit With Medically Unlikely Edits Denials?

It can happen to any individual who is involved with coding, dealing with MUEs can end up being a nightmare if you do not know when and how to use them. MUEs, which is short for the term Medically Unlikely Edits, happen to be put in place to try and help limit the amount of billing errors. The more you understand them, the better off you will be when you find that you need to use them. If you are worried about dealing with MUEs, then you really should know that you are not alone. Luckily, there are a couple of things that you can look to and keep in

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Correctly Coding the Top 4 Pediatric Parent Consultations

No one has to tell you that the world of pediatric medicine is fast paced and along with unpredictable kids come unpredictable medical billing situations. If you process medical billing for pediatric physicians, you may or may not have run across a situation for determining what diagnoses would apply when parents come in to discuss their child’s health issues. If you’re wondering if there is a single code, the answer is yes. A parent conference falls under V65.19 (Other persons seeking consultation; other person consulting on behalf of another person). In other words, the code describes a person seeking “advice or treatment for non-attending third party.” Since a parent has

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Sick Visit Claims Could Be Costing Your Practice

Did you know you might have a cash flow leak and not know it? It’s not uncommon for practices to file medical billing claims without meeting requirements for the use of Modifier 25 in bundled sick claims and doing so could very well be costing your practice valuable reimbursement revenue. Fortunately, there are some simple rules to follow to ensure that you’re getting the best reimbursements for your claims. First of all, make sure that you know exactly what the payer requires for reimbursement on these claims. Next, make sure you document exactly what caused the encounter and what the outcome was. This shows a logical flow of information and

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With Code 21 – It’s Location, Location, Location!

As you know in processing medical billing for hospital based claims, location of services is everything and you must be certain that the correct place of service coding is used. That is where code 21 comes in handy. Place of service code 21 is used in medical billing for all inpatient hospital care. Code 23 is a lesser used code, but also useful. Admittance of a patient to the hospital will make it necessary to use the inpatient hospital POS code 21. Many medical billers get confused when the emergency department comes into play. They question whether or not they should use place of service code 23 for emergency room-hospital,

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Increase Your “Foreign Body Removal” Reimbursements

Most foreign body removal procedures are pretty black and white. Only on the rarest of occasions is there a complication and most of the claims can be handled in a similar manner. However in the even the physician is called on to perform soft tissue removal in a FBR procedure, you need to know how to code your medical billing claim s so your reimbursement won’t be paid only partially or denied. Make sure in this event you code the service with 10121 (Incision and removal of foreign body, subcutaneous tissues; complicated). Some giveaways that the FBR procedure was more complex than normal will be found in notes and procedurs

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