Archive for the Week of September 4, 2005

Archive for the Week of September 4, 2005

Welcome to the medical billing blog archive for the week of September 4, 2005.

Here you will find links to every article added to the Outsource Management Group web site during the week of September 4, 2005.

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

Top 3 Types Of Appeals Filed In Your Medical Billing Claims

Top 3 Types Of Appeals Filed In Your Medical Billing Claims Filing appeals for your denied medical billing claims is never a fun affair. In many cases, these denials of claims could have been avoided completely with just a little bit of preparation with your medical billing claim. The number one type of appeal filed on medical billing claims was on claims denied due to diagnosis reasons. This can be due to incorrect coding, under or over coding and the biggest offender in this category dealt with medical billing claims that were coded using outdated codes. The ever changing world of diagnosis codes is not easy to keep up with

Published By: Melissa C. - OMG, LLC. CEO | No Comments

DOA One Of The Hardest Medical Billing Claims To File

DOA One Of The Hardest Medical Billing Claims To File When a patient dies en route or shortly after being admitted, coders and billers often struggle on the amount of, if any, procedures performed by the physician prior to the patient’s expiring. Here is a good example of how to code one situation: EMS contacts the ED for CPR direction, and is directed by the ED physician pertaining to defibrillation and medications. When EMS brings the patient into the ED, the doctor examines the patient and decides there isn’t cause to continue CPR and pronounces the patient dead. On your medical billing form, you would usually bill 92950 (Cardiopulmonary resuscitation)

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Medical Billing For Types Of Medicare.

Medical Billing For Types Of Medicare. Medicare can be tricky to submit medical billing claims to. They require each and every line regarding procedures performs to be documented and noted on the medical billing form prior to submission. Failure to do so can get your Medicare medical billing claims only partially paid or worse outright rejected, and rejected medical billing claims not only stop your revenue flow back into your practice, it also ties up your staff with the duties of pulling patient files, checking the forms, refiling the medical billing forms, double checking the file to make sure everything is documented and then re-submitting the claim to Medicare. Another

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Medical Billing Tips Consider Dermabond a Simple Closure

Medical Billing Tips Consider Dermabond a Simple Closure When filing your medical billing claims for laceration repairs. Most carriers recommend that you code Dermabond as a simple closure when preparing your medical billing forms. If the wounds are located in the same anatomical area you should add these wound lengths together and only report one simple repair code on your medical billing form. A good example of this is if a surgeon repairs a patient’s lacerations using Dermabond in three separate places on the left arm; in order to report the procedure performed correctly, you should choose the most accurate code from the 12001-12007 series (Simple repair of superficial wounds

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New Patients And Old Patients – Medical Billing Differences

New Patients And Old Patients – Medical Billing Differences There is a lot of confusion in many physician’s offices on how to handle the coding & medical billing of services rendered to an old patient and a new patient. New patient medical billing requires a lot more work than an established patient and this is reflected in the new coding requirements as well as reimbursement for your medical billing. One key to differentiating between new and established patients is understanding two terms used in CPT’s definition of a new patient: “professional services” and “group practice” and the understanding that Medicare’s definition of a new patient is slightly different than CPT’s.

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ICD-9 vs. CPT Coding

ICD-9 vs. CPT Coding In the world of medical billing, coding of the medical billing forms actually requires the use of two coding systems, one that identifies the patient’s disease or physical state (the International Classification of Diseases, 9th Revision, Clinical Modification, or ICD-9-CM, codes) and another that describes the procedures, services or supplies you provide to your patients (the Current Procedural Terminology, or CPT codes). To differentiate between these coding systems, think of it this way: CPT codes describe what services you perform, and ICD-9 codes describe why you do it. Each service you render to a patient becomes a line on an insurance claim form. Your level of

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CPT Code 99211 In Medical Billing

CPT Code 99211 In Medical Billing Understanding when to use CPT code 99211 on your medical billing can boost your practice’s revenue and improve documentation which will result in greater returns on your reimbursements. Qualifying for 99211 service on your medical billing is not too hard, the patient simply must be established, and an E/M service must be provided. Additionally, the service must be separate from other services performed on the same date and neither the presence of a physician nor any documentation of key components are required as part of the documentation for the medical billing. Another use for Code 99211 is patient education, simple rechecks, medication reviews and

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ICD-9 Coding Accuracy In Your Medical Billing

ICD-9 Coding Accuracy In Your Medical Billing When you talk about the procedures you do and services you perform for your patients, you have words to describe what you did: patient eval, Pap smear, sinusitis. When third-party payers examine and refer to the work you do, it’s simply broken down into numbers. Almost every medical condition, service and supply can be identified by a numeric code, primarily because Medicare and other third-party payers require numeric coding on claim forms. They set the payment rules, based on these codes so the proper coding must be used so your practice can be reimbursed for your services. It’s not easy to being fluent

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Top Five Types of Service Most Frequently Appealed

Top Five Types of Service Most Frequently Appealed A recent study conducted by Medicare showed that the top five types of services submitted on medical billing forms for payment fell under the following five catagories. Evaluation and Management – 99200-99499;Pathology & Laboratory – 80000-89399,G0001,P0000-P9999;Radiology – 70000-79999, G0130-G0133, G0236;Ambulance – A0000-A0999;Chiropractic Manipulative Treatment – 98940-98943.Most of these claims were submitted directly by physicians’ offices and not by medical billing firms. As you are aware, evaluation and management, pathology and laboratory and radiology services are all high volume procedures but with the levels frequency for these procedures the medical billing should be able to be more streamlined for most offices. Your medical

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To Ask About Electronic Medical Records Software

Important Questions To Ask About Electronic Medical Records Software If you’re a private physician, you have probably looked at more electronic medical records (EMR) programs than you care to remember. When looking at EMRs there are a number of questions you should ask: What is the licensing of this product? Meaning do you have to pay every time you load it on a computer in your office; so you and your secretary and office manager can all handle billing?. Some companies have a site license for which you can put your EMR software on a number of PC’s in your office without restrictions on program users. Other software is sold

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