Archive for The Day of August 15th, 2006

Archive for the Day of August 15th, 2006

Welcome to the medical billing blog archive for the day of August 15th, 2006.

Here you will find links to every article added to the Outsource Management Group web site during August 15th, 2006.

You can browse this day's archives by clicking the "More" button from any of the excerpts below.

Catching Medical Billing Denials Before They Happen

The biggest medical billing problem is getting denied payment for a claim. A service for which many patients are denied is counseling to quit smoking or the cessation of other tobacco product related use counseling. Since this is a voluntary activity, many payers have a hard time reimbursing for this service. The patient either has no coverage for the counseling under their plan or is only allowed a certain amount of counseling sessions for the smoking cessation purpose. What happens if another physician has already done medical billing for these counseling sessions? Chances are, you would not get paid. In many cases you won’t find out until you have already

Medical Billing When There Isn’t An Exact CPT Code

Certain areas of the body do not have CPT codes for procedures, such as an MRI done on a hip of a patient. You need to use the codes 73721-73723 (Magnetic resonance imaging, any joint of lower extremity). The hip joint falls into this medical billing category because it is a lower extremity joint. Doing medical billing for bilateral hip MRIs is also a bit more complicated. Different payers require different modifiers for payment. For example, Medicare prefers that bilateral MRIs be reported with LT (Left side), and RT (Right side), along with the medical billing modifier 76 (Repeat procedure by same physician). You should check with the various payers

Denials Due to Code Non-Recognition

In some cases you may get a medical billing denial due to non-recognition of the coding used. In a lot of cases, this is due to the medical biller jumping the gun and using a code that was due to be released too early for reimbursement. Normally when a new code is introduced, an effective date will be set and that is the given date for all service providers to begin using that particular billing code. It is not permissible for carriers to deny claims for no recognition if the code effective date has passed. There are instances in medical billing where code no recognition is acceptable. A payer can

To Bundle or Not to Bundle That is the Question

In medical billing, there are many Ob-Gyn codes that should be bundled, while others should not be bundled. The current procedural codes 58720 and 57283 frequently bring up this “to bundle or not to bundle” question in medical billing. It is important to know when to bundle certain Ob-Gyn medical billing codes and when to bill them separately. The current procedural terminology code 58720 (Salpingo oophorectomy, complete or partial, unilateral or bilateral) can be billed completely separately from a colpopexy (57283). This means that if your physician does both of these services at the same time, you can do medical billing for both procedures. There is no bundling. Separate reimbursement

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