Archive for the Week of August 3, 2007

Archive for the Week of August 3, 2007

Welcome to the medical billing blog archive for the week of August 3, 2007.

Here you will find links to every article added to the Outsource Management Group web site during the week of August 3, 2007.

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

Questions About NCCI Edits for Unusual Situations

There have been questions regarding the use of carotid Doppler (93880) being performed on the same day as venous Doppler (93965, 93970, 93971); some insurance companies do not want to reimburse both procedures as it is unusual to perform both with one service period. National Correct Coding Initiative edits don’t prevent you from reporting these codes together, but the payer may be questioning the medical necessity of performing both services on the same day. Doctors don’t usually order both of these exams for the same patient on the same date of service. If there was a reason and you can show hard documentation as to the necessity of having both

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

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

Neonatal Dilemma – Should You Have Separate Charges for Separate Procedures?

The smallest patients can present the largest and most confusing problems in medical billing. There can often be confusing scenarios that occur during neonatal procedures that many medical billings can find confusing. 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

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