If you are finding that you're chasing medical billing claims and having a lot of rejections, it may not be your staff, it might be that they are unable to keep up with the fast pace of the ever-changing medical billing industry. It might be time to consider outsourcing your medical billing claims. And you can get a lot more than just have your medical billing claims handled.

We can provide a complete medical billing service for your practice. It will include filing both your electronic and paper claims along with any necessary consulting. We also offer comprehensive medical coding services. This includes analysis of your claims, coding audits and consulting.

Need help with your accounts receivable? Outsourcing your medical billing claims can help with that problem too. We can offer practice management solutions to help your staff deal with the coding changes and knowing the best way to package your medical billing claims to get the most out of your reimbursements.

If you need credentialing, we can help you with that too. As you know, credentialing can be a painful process of filling out forms and then waiting for approval from various insurances. We will file your credentialing paperwork and then follow up until you are approved and we can handle any speciality nationwide.

The time to outsource your medical billing claims has never been better. Look into how outsourcing can save you time and money today.

Feeling stretched too thinly? If so you will find our medical billing services can help you tremendously and it doesn't matter if you're located within Indiana or outside the state, we can handle medical billing claims nationwide.

When you decide you'd like to use our medical billing services, we know that each provide and practice is completely individual in their needs and we will consult with your to find out what your concerns are regarding your billing. We will set your office up to communicate your medical billing claims via secure transmission to our office. If you're interested in the rest of our Medical Billing Services we can also do the following to help you and your practice:

We will do all your data entry for you. Your medical billing claims will be filed for you. Nearly all will be filed via electronic claims methods but we still can handle manually handling paper claims whenever necessary.

We can mail our statements to your patients that will be mailed on your behalf from our office. If you have specifics that you want on your statements and you have a certain way you like to handle collection accounts and past due notices, let us know, we won't change a thing and will continue to bill and handle claims exactly as you wish. We can also handle your payments. As the payments and EOBs are received related to your practice. We will enter them in our database. Your staff can log into to a patient's account at any time and see the updated information at anytime as the changes are immediate.

If you have a problem with denials, simply outsourcing will lower your denial rate to around 1% of your total medical billing claims, in the event there is a denial, we will fight to get your claim approved.

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 means the same as 99341 except with an established patient), the only POS code available for use is 12. This means home.

Many billers get confused with these medical place of service codes. If a patient is in an assisted care center, many people consider this a home and bill with place of service code 12. This would be incorrect. POS 12 is reserved for house, apartments, etc visits. There is actually a more specific code for an assisted care center in medical billing, the correct POS code would be 13.

Basically, for every current procedural terminology code, there is a correct place of service code that corresponds to it. if these medical codes are used incorrectly in billing, it will cost your practice time and money. Insurance companies will deny the claims and your office will have to correct the problem. With the use of an outside medical billing company, you can erase this problem from your mind. Medical billing companies are versed in the correct billing procedures for every medical service. They check claims for accuracy before they are submitted and take care of any claims that come back unprocessed. Correct medical billing POS codes are essential for maximum practice profitability.

It's hard to let go of what you might deem the financial control of your practice. Hiring a medical billing consultant can seem like you're adding expenses instead of cutting them down, especially if you have never outsourced your billing. If you've always discounted outsourcing your medical billing claims because you feel as though you would be relinquishing control over your billing, read on - you'll find that is not the case.

Actually outsourcing your medical billing and coding needs through a consultant is one of the smartest business moves you can make. Don't think you have to use a local company, many medical billing firms have branch offices in an area near you, but others may be miles to hundreds of miles away, and thanks to the power of the internet with secure connections and software advances that allow you to transfer your patient billing records while upholding the utmost in privacy standards, with just a click of your mouse, makes the job of shopping for a medical billing consultant to hand the billing paperwork for your busy practice all the easier.

Your staff won't have to spend long hours at the copy machine when you outsource, most records can be transferred via computer to computer using secure, encrypted technology. Many medical billing consultants offer real time updates of patient accounts, so if information is needed on where a particular claim stands, your staff can click and see!

Outsourcing to a medical billing consultant will insure that your claims are coded and submitted properly because that's their business! There are no interruptions, patients asking questions, and general day to day running of your practice. A medical billing consultant can devote 100% of their time to handling your coding and claims. That way your cash flow is steady and your practice will grow!

Time is money in your practice and if you outsource your medical billing through a consultant you are definitely making the most of your time and because of your smart choices, you'll see an increase in your revenue flow for your practice.

January 2007 brought more changes to the medical billing industry. Certain codes were "retired", new codes were added and others simply had their meanings broadened to encompass their meanings. If your practice doesn't keep up with the changes and know in advance of coming changes, you can be losing out on legitimate revenue for services rendered. Some practices are losing up to one fourth of their revenue simply because they staff isn't aware of the best techniques for reporting procedures.

Undercoding is another way many practices don't get the full value for their services. If your staff is undercoding your medical billing claims you are definitely missing out on reimbursements. Also, partially paid and rejected claims are also a problem that will stall your revenue flow to a trickle.

If you're ready to leave the worry of keeping up with the medical billing and coding changes; consider that it might be time to outsource your medical billing to a third party partner. You can rest assured your claims will be coded correctly, the best fitting CPT codes will be used and your claims will be submitted in a timely manner. Additionally, if there are any problems with the claim, your staff won't have to stop servicing your patients to go pull files and wade through reams of medical billing forms; your medical billing partner will handle those situations too!

Keeping up with the fast paced changes is tough and it shouldn't affect your business but it does. Look into outsourcing your medical billing in 2007 and reap the rewards all around.

When you have a procedure that can cover two close but distinctly different areas such as a facial and a dental nerve block, you need to make sure that your claim encompasses exactly the procedure that was done or you may wind up with a denial of your claim.

A common situation would be if the ED physician performed a diagnostic nerve block on a patient complaining of pain in the floor of her mouth and her bottom set of teeth. You would want to be certain that you chose 64402 (Injection, anesthetic agent; facial nerve) for facial nerve blocks, not blocks in the mouth or jaw. The determining factor is that the surgeon treated a branch of the trigeminal nerve, not the facial nerve.

On the claim, report 64400 (... trigeminal nerve, any division or branch) for the nerve block. Other 64400 scenarios: Areas affected by the trigeminal nerve and its branches, and therefore coded with 64400 for nerve blocks, include:
* the body of the mandible and the lower portion of the ramus
* upper and lower teeth
* floor of the mouth
* anterior two-thirds of the tongue
* gingiva on the lingual surface of the mandible
* gingiva on the labial surface of the mandible
* mucosa and skin of the lower lip and chin.

To ensure proper payment, back up your medical billing claim with the proper documentation to show the reason for the facial or dental block and that will allow the carrier to see why this code was chosen along with the necessity of the procedure. This will enable you to realize reimbursements instead of rejections on these type of claims.

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 absence for any reason and a substitute physician fills in, you need to add the Q6 modifier to Medicare claims the sub handles if you want to ensure reimbursement for the services that the sub provides.

If you're wondering why, the reason is that when a substitute or locum tenens physician handles patients, Medicare wants to see specific modifiers on claims. This is to make sure that the time limits on locum tenens doctors are strictly observed.

In order to be reimbursed, make sure that modifier Q6 (Service furnished by a locum tenens physician) is attached to all codes for procedures performed by the substitute physician. This lets the Medicare carrier know that you are coding for a locum tenens physician. Without the modifier, you'll likely receive a denial for the claim.

Since many private carriers are adopting more and more of Medicare's standards for payment on services; before filing a locum tenens claim with a private insurer, verify with the plans as to their requirements for locum tenens billing -- and whether or not they even recognize it. Some good questions to ask are
* Do you recognize modifier Q6?
* Which provider's ID should be reported for the services?
* Does the locum tenens provider need to be credentialed with the payer, even if only temporary privileges?
As always - write down the full name and position of whomever you speak with and the time and date of your call in case you need to track that person down again.

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 should also list a diagnosis code for the wound in I3. The I3 is important to complete when you're doing medical billing for long term care patients as it reports additional conditions that affect a patient's health.

Since pressure ulcers are extremely common in long term care for patients that are invalids, there is a Section M that provides options for identifying both pressure ulcers and stasis ulcers but not for other types of ulcers. If another type of ulcer is to be reported on your medical billing claim, use the form and then also list the corresponding ICD-9 codes at I3, says Smith. In this case, you should list:

A confusing part of medical billing for long term care comes from the I3 itself where some I3 coding training indicates that you don't need to include diagnoses codes for conditions that are addressed elsewhere on the MDS. However, many carriers, including Medicare do require that the type of wound be specifically spelled out. Additionally, once the ulcer is healed, be certain to take it out of section I3.

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 fact that many practices are losing up to one solid forth of their revenue due to small inconsistencies in reporting. Medical billing codes can change, the way a particular carrier wants their medical billing claim reported can change and Medicare never seems to stop updating and changing their criteria for what constitutes a fully reimbursable procedure.

Your staff can spend valuable office time researching medical billing claims or you can outsource your medical billing and let your staff do what they do best : service your patients and help keep your practice running smoothly.

If you're ready to get away from the paper chase of never ending medical billing changes, consider outsourcing a proactive way to begin 2007.

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, you should instead report a diagnostic colonoscopy (45380, Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple).

The coding changes for a situation where the surgeon visualizes and biopsies the polyp, you should change the primary diagnosis from V76.51 (Special screening for malignant neoplasms; colon) to, for instance, 211.3 (Benign neoplasm of other parts of digestive system; colon).

The majority of carriers have states they want to switch the polyp diagnosis for the excision a few want to keep the V code. If you're not sure in your medical billing, avoid a delay or rejection by asking what the carrier's preference is.

One point that many medical billers find confusing is the correct procedure for coding the use of tissue adhesives when used for wound closures.

The answer to this question will be different depending on which entity is paying the medical billing claim. When you code for the use of tissue adhesives, including Dermabond; Medicare has its own guidelines for reporting this procedure that you need to follow to be reimbursed. You should report G0168 for Medicare patients only. If you are reporting the procedure for a non-Medicare patient, you should use the CPT code that is the equivalent and that is 12001-12018 series (Simple repair of superficial wounds ...).

Another tip for reporting this claim to Medicare is you may only use G0168 for Dermabond-only laceration repairs in both the inpatient and outpatient settings. If sutures or staples were also used you will have to report this as a layered laceration code on your medical billing form.

Something you may not be aware of is that Medicare assigns a payment status indicator of "N" to G0168, meaning it represents an incidental service. You can report the code but you won't receive any reimbursement for it from Medicare payers.

Private payers will have different guidelines, a quick check with the payers to see if they follow Medicare guidelines for this type of procedure will let you know whether or not to expect a reimbursement for the service.

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 the right to discuss the treatment and medical issues for their minor child it's per missable to bill for the consultation.

The counseling diagnosis code can be used when the patient is present or when counseling the parent/guardian(s) when the patient is not physically present as in over the telephone. Although carriers may require supporting documentation for coverage of the encounter, so make sure you indicate the discussion's topic and the documentation should be signed off on by the attending physician. In case of an as yet undiagnosed concern, you can also check if payers want a secondary diagnosis that indicates the topic.

There are numerous reasons for consultations that include these top four common reasons:
* ADD/ADHD -- 314.00, Attention deficit disorder; without mention of hyperactivity; 314.01, Attention deficit disorder; with hyperactivity
* anxiety -- e.g., 300.00, Anxiety state, unspecified
* depression -- e.g., 311, Depressive disorder, not elsewhere classified
* obesity -- 278.00, Obesity, unspecified.

Use the total face-to-face time that the pediatrician spends with the parents to select the service code. Careful supporting documentation of the time elements is critical and will result in reimbursement for your medical billing claim.

Locum tenens is a confusing situation in the case where a physician takes a vacation or otherwise isn't available and hires a physician to see patients on site, Medicare can deny the claim unless it is properly documented. The reason is that Medicare is very strict about seeing specific modifiers on medical billing claims that involve a substitute or locum tenens physician.

Further, your medical billing claim must have the time limits observed for locum tenens doctors. Otherwise, Medicare won't pay for their services rendered to patients. Also, you can't hire a locum tenens as extra staff. This includes situations where the regular attending physician goes on vacation, has an illness with a lengthy recovery time, maternity or family healthy leave, or educational reasons such as attending continuing medical education classes. When you use a locum tenens physician it must always be in the capacity as a temporary replacement that substitutes for the services of a specific physician.

Remember to use Modifier Q6 on all your locum tenens claims. There are some extra steps that must be taken in order for your locum tenens claims to be reimbursed by Medicare. The Q modifier should be listed as a procedure code so Medicare knows you're claiming services rendered by a locum tenens physician. If you don't use the modifier, you claim will likely be denied. Also the maximum time limit for billing for locum tenens physicians is currently sixty days for Medicare and private payers will have different criteria for length of service. Call before you file is a good rule of thumb, you may be missing reimbursements if you don't. Some good questions to ask would be if the payer requires the locum tenens be credentialed even for a short period of service time; also, which provider's ID would they prefer to be reported?

Using the correct modifier and a call before you file can save you a lot of hassles and delays in receiving your reimbursements for the locum tenens type of medical billing claims.

Put yourself in this medical biller's shoes and see if you would file this claim correctly.

A patient that recently had a hysterectomy presented to the ED with symptoms needing treatment. The physician noted that the patient was suffering from "estrogen withdrawal with menopausal symptoms." A level three evaluation and management service was performed on the patient; what diagnosis code would you use? There's no specific code for estrogen withdrawal.

Stumped? In this case you should use more than one code as there is no specific code for this service. Break out the claim to show the patient's main complaint and reason for the ED visit and then to show that she is a recent hysterectomy patient.

You will want to report code 99283 (Emergency department visit for the evaluation and management of a patient, which requires these three key components: an expanded problem-focused history; an expanded problem-focused examination; and medical decision-making of moderate complexity) for the E/M service. Then you will want to pair that coding with 627.4 (Symptomatic states associated with artificial menopause) to 99283 to represent the patient's estrogen withdrawal. Then, to back up the history of patient by attaching V45.77 (Acquired absence of organ; genital organs) to 99283 to signify that the patient had a hysterectomy.

Good documentation will show that this patient had a legitimate need for treatment and management and you are more likely to receive reimbursement for your medical billing claim if you meet this criteria.

If you don't properly meet certain requirements for the use of Modifier 25 in your sick visit bundled medical billing claims, you could very well be losing money and not know it.

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 will better help the payer see that the services rendered will qualify for full reimbursements.

Additionally, be aware that the RVU system makes no adjustment for codes with modifier 25. Although a plan may pay such claims as the policy allows, insurers that follow CPT rules should generally be paying each CPT code in full in this instance as long as a distinct entry is made on the medical billing form. Additionally, make sure that your charges are consistent and reflect real pricings for services rendered.

A red flag for many payers is two of the following scenarios:
* Enter a $0 charge for the sick visit service (99201-99215), and bill the preventive medicine service (99381-99397) above the contracted rate

* Split the well care charge in half and apply it to the sick visit.

Remember, raising your price on a single visit may get your entire claim denied. The right way is to charge the usual amount for your services and back up all services with strong documentation.

Neonatal patients seem to present confusing scenarios for many medical billers. It could be due to the fact the patient is so tiny that many of the procedures seem related to split out but in many cases, claims for neonatal services are incorrectly bundled together.

A good case in point would be if a neonatal patient presented with a fever. The physician then did a urine catheterization (51701) and a spinal tap (62270) in the office. In many cases, the medical biller might have bundled these claims together but that would be incorrect as they are two distinctly different procedures even though they were performed at the same visit.

Also, a urine catheterization (51701, Insertion of non-indwelling bladder catheter [e.g., straight catheterization for residual urine]) and lumbar puncture (62270, Spinal puncture, lumbar, diagnostic);do not have edits placed on the code pair by NCCI so no modifier would be required for reporting this procedure. If you do use modifier 51, expect Medicare to reduce reimbursement by roughly 50%.

However, in the case of this type of procedure, your medical documentation documenting both the necessity of the procedures as well as the outcome should be iron clad to insure that you get maximum reimbursements on your medical billing for these services.

Outsourcing has become a dirty word in many industries due to the substandard nature of the work that is produced in many niche markets. However, with a little due diligence and making a smart choice with the company that you choose to partner with for your medical billing - it can be a rewarding experience for your practice.

A medical billing partner like Outsource Management Group can not only process your medical billing, they also have practice management services that can help you keep tabs on your accounts receivable so you have a steady influx of revenue at all times. Another great feature of outsourcing is that OMG can get you credentialed. The more types of insurance you accept the more revenue your practice can benefit from.

One of the biggest selling points of outsourcing for most practices is the fact you will see turn arounds in your medical billing claims shrink from roughly thirty days to approximately fourteen days or less. And if you're doing your own coding and medical billing claims, there is a good chance you may be missing as much as one-fourth of the revenue your practice deserves simply for not knowing the most cost beneficial way to submit and bundle medical billing claims.

A medical billing partner's job is to make sure that the practice receives the best possible reimbursements for their medical billing as well as keeping on top of the current changes in the coding. Add in the practice management and credentialing services and how can you lose?

In the fast paced world of medical billing, it can be difficult for your staff to keep up with not only a busy practice, patient phone calls, needs that crop up and then the medical billing too. If a member of your staff misses a line item on your medical billing or uses an out of date code, it can directly affect your revenue in the form of a claim that isn't fully paid or worse a rejected item that requires your staff to pull the file, review the documentation and then resubmit the claim to the carrier.

This takes valuable time away from your practice and has your staff chasing paperwork when they should be servicing your patients and helping your practice grow. Not to mention, you're still not getting reimbursed for services performed until that claim is re-submitted, accepted and paid.

As stated before, in some cases the rejection will be due to your medical billing form either having incorrect coding or out of date coding. Codes and modifier requirements can change more than once a year so it is important that if you're going to be doing the coding within your practice, that your staff remain up to date on the latest filing requirements.

In other cases, a rejected claim by a carrier is due to the pre-certification requirements not being met. Many times, procedures will need to be pre-certified by the carrier prior to services being rendered or the carrier simply will not honor the medical billing claim when it is filed. One way to cut down on your claim rejections, is to have your staff document when they call for a pre-cert when a patient needs a procedure performed.

If you find your practice no longer has time to chase the paperwork, it may be time to outsource your medical billing claims. Your medical billing partner will not only submit your claims electronically, just by having a service that can submit your properly coded claims via EMS, your rejection rates will only be about 1%-2%. Not to mention, they stay on top of your claims and can even get your practice certified with multiple carriers - this will enable you to grow your practice and realize more profit than ever before!

Using a modifier incorrectly can cost you in terms of reimbursements and time. Carriers are closely scrutinizing medical billing claims for incorrect usage of modified 59. There are two main areas that you can concentrate on to avoid getting his with denials or pay backs and insure that you use the modifier correctly.

A study of the OIG found a 40% error rate for modifier 59 and you can double check your billing. First of all, in order to use modifier 59 there must be services performed at separate regions. Fifteen percent of the OIG's audited claims using modifier 59 had procedures that weren't distinct because "they were performed at the same session, same anatomical site, and/or through the same incision,".

Be certain that the physician has worked on two distinct areas of the body or more and make sure that your medical billing documentation backs it up completely. This will avoid your claims being bundled as one procedure and lessening the reimbursement rates on your medical billing claims.

Another valuable tip for using modifier 59 correctly will involve the secondary code. Make sure that you use 59 on the secondary code and once again make sure your medical billing documentation is iron clad. Each edit for the NCCI will consist of code 1 and code 2, use 59 in the code 2 column where appropriate.

If you're missing using modifier 59 on your medical billing claims, you're missing out on valid reimbursements for services performed, make sure you're getting the maximum reimbursements for your medical billing claims and stay on top of the latest trends or it may be time to consider outsourcing your medical billing to a company that can stay ahead of the latest changes for you.

Avoid Fee Reductions By Reporting Modifier 52 Properly

If it has become a habit to append modifier 52 every time your medical billing has a service that doesn't exactly meet a CPT code description, you could be unknowingly cutting your compensation on your submitted claims.

AMA CPT guidelines state that modifier 52 should be used when the physician partially reduces or eliminates a service or procedure at his own discretion. The CMS guide lines state as follows: "when a procedure/service performed is significantly less than usually required".

What you should do is report the code as usual for the procedure and then append modifier 52 to show that the services for the procedure were reduced.

What you need to watch out for is when the payer has different coding guidelines, that's when using this method of reporting can cost you monetarily. If you have a situation where you will need to use modifier 52 to show the procedure was lessened from the services included in the code; first of all, make sure that your medical documentation backs it up and is signed off on by the physician. A cover letter explaining the use of modifier 52 is also a good idea for some carriers. Second, check with the payer and find out how they want this reported, this will ensure that you get the maximum reimbursements for the services reported as well as easily meeting the payer's needs to obtain those reimbursements.

Pediatrics has many medical billing codes that were created just for the use of describing procedures. However, there are other areas of medical billing that do not have these specific codes for children. This can make coding hit or miss unless you know the nuances of what the carrier wants in order to get the maximum reimbursements for procedures performed. A common dilemma is with CPT code 99293 and its use for outpatient emergency room exams for an infant or if code 99291 should be used.

The medical billing code 99291 means critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes. You would use this code if a patient came into the emergency room and was there for a half and hour up to 74 minutes. This is pretty straight forward in medical billing. The confusion comes in when using code 99293. This means Initial inpatient pediatric care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age. This code should only be used if the infant is admitted inpatient.

When doing medical billing it becomes confusing because there is no code specifically for outpatient emergency room visits for children. There is only a child specific medical billing code for inpatient visits. A simple rule of thumb in medical billing is that the location of service must match the CPT code. This is because inpatient evaluations get reimbursed at different levels then outpatient emergency room visits.

There are many rules and regulations when it comes to current procedural terminology codes. Sometimes, you can find they are too much to keep up with; if you're finding your staff and yourself overwhelmed chasing billing and medical documentation, it may be time to consider outsourcing your medical billing to a partner that can make sure the latest coding regulations are followed and your practice receives the maximum reimbursements allowed for procedures performed.

This article will make you a bilateral renal arteriogram medical billing pro. There are many code confusions with this increasingly common surgical procedure. Some payers will not pay a cent if you submit your medical billing with the wrong code combinations. However, doing medical billing for renal arteriograms can be quite simple.

There are two codes one should report when doing medical billing for a renal bilateral arteriogram. The current procedural terminology code 36245 should be reported twice. Then the Current Procedural Terminology code 75724-26 should be reported. Do not make the mistake in adding a G0275 to your claim because the renal arteriography already includes that service. If you do medical billing separately for this service, you will probably not get reimbursed for either one. The only time you would use G0275 in medical billings is if the doctor does a nonselective renal arteriogram during the surgery as a cardiac catheterization.

Remember your modifiers in medical billing. Modifiers can save payers and billers valuable time and effort. Different payers require different modifiers for a renal arteriogram done bilaterally. To be safe, you should report an LT and a RT modifier to each of the 36245 CPT codes. If you add a modifier 59 (distinct procedural service) as well, it might cause less confusion when payers examine the medical billing.

One important note to keep in mind when billing for a medical bilateral renal arteriogram is to omit the 75625 current procedural terminology code. It is not appropriate in this situation and should not be included in your medical billing. Make sure your medical documentation is iron clad and signed off on by the physician and you should be able to reap the rewards in the form of full reimbursements.