Archive for the Week of September 1, 2006

Archive for the Week of September 1, 2006

Welcome to the medical billing blog archive for the week of September 1, 2006.

Here you will find links to every article added to the Outsource Management Group web site during the week of September 1, 2006.

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

Interesting News About Medicare Medical Billing

In a recent study done concerning Medicare billing, researchers discovered that more than 92% of the claims paid were for beneficiaries with three or more conditions. Aggressive treatments of more common ailments such as obesity and metabolic syndrome have triggered escalating spending on medical billing turned into Medicare for reimbursement. The researchers concluded that aggressive treatments on these type of conditions will snowball into additional spending in years to come. Obesity is a driving force behind many of the multiple ailment filings and the obesity rate has nearly doubled since 1987 and the number of claims regarded obesity related illnesses since that time has tripled. Long term management of chronic

Know How to Code and Document Wound Debridement

Sometimes a wound gets worse before it gets better and knowing how to properly code it will enable your office to get the maximum reimbursements on your medical billing instead of having the treatment bundled. Debrided ulcers are not uncommon and knowing how to correctly document the staging and coding on the MDS is most of the problem. It is difficult to assign a stage to a wound you can’t see and the MDS does not allow you to bill for a wound you can’t stage. A good rule of thumb to use is to stage the wound at stage 4 (necrotic eschar is present) until the exact stage can

Cutting Losses with Consolidated Billing in Rehab Facilities

If you’re finding that Medicare is kicking back a lot of your claims for being non-excluded services, there is something you can do to help your reimbursements – consolidated billing. Use heavy documentation and case manage all physician visits. Follow up and use detailed documentation for each service the patient received. A good example of this is if a patient is in a rehab facility for a hip fracture and needs to see an orthopedist for follow-up, call the doctor to schedule the appointment and ask what the surgeon will need, such as imaging or lab work. Tell the managing physician to order those services and have the results sent

Talking Confidentiality

Confidentiality is a huge concern among patients and the medical industry at large. No other industry goes to such lengths to protect the data and privacy of their consumers. A question of authorization forms comes up frequently. A common situation is when a doctor’s office is asked to fax absentee notes verifying visits or the authorization to administer medications directly to a school or a camp. In the past, this was permissible, but in recent years with the patient confidentiality laws becoming more strict than ever; the rule of thumb has become that this is not standard office practices any longer. Since the forms would be faxed to a central

Recording and Coding Wounds Properly

Any person who is involved in the medical field already knows just how important it can be when it comes to putting down the proper codes for each and every procedure. Taking care and making sure that the right code is recorded for the proper procedure can ensure that there will not be any problem down the line with health care providers and insurance carriers. However, sometimes it may be a bit more difficult to decide exactly which code needs to be used in every instance. Take the time to find out what the medical code should be before you end up reporting the wrong one and this could alleviate

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