Archive for the Week of September 11, 2005
Archive for the Week of September 11, 2005
Welcome to the medical billing blog archive for the week of September 11, 2005.
Here you will find links to every article added to the Outsource Management Group web site during the week of September 11, 2005.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Emergency Medicine Medical Billing
Emergency Medicine Medical Billing Emergencies can not be planned and they can’t be scheduled. There are no preapprovals and a lot of times documentation is sparse and these are among the hardest medical billing claims to get paid. Emergency procedures are performed in a fast paced environment and there can be several people performing multiple duties and not all those procedures get noted on the documentation. When it comes time to compile the medical billing form. The coding will have to considered carefully. You obviously can’t have certain procedures done without others being included. For example there may not be the suturing procedure listed as it might have gotten missed …
Reasons For Medical Billing Reversals
Reasons For Medical Billing Reversals Reversals can happen for a myriad of legitimate and not so legitimate reasons. In a recent study, the top reasons for medical billing reversals are as follows: 1- Incorrect payable diagnoses codes, the biggest offenders in this category were: Modifier 59 – distinct procedural serviceModifier 76 – repeat procedure by same physician Modifier 24 – unrelated evaluation and management service by same physician during postoperative periodModifier 25 – significant separately identifiable evaluation and management service by same physician on the day of a procedure. 2-Provider Billing Errors – As long as medical billing is coded by humans, there will be errors, that’s just a fact …
Payers Treat Group Practices as 1 Provider
Payers Treat Group Practices as 1 Provider Medical billing rules can get hazy when dealing with group practices. It is difficult to determine if physicians within a group should bill separately for follow up care if another physician performed the actual surgery. There are rules to follow in this type of situation that make medical billing easier to understand. When there is a group of physicians in the same practice, usually one does surgery. With surgery there is usually follow up care that is bundled in the CPT code for medical billing. This means that surgeons cannot bill separately for follow up care and for the surgery. This also goes …
Hospital Coding For Medical Billing Claims
Hospital Coding For Medical Billing Claims Hospitals can be fast paced, shift changes and sometimes the lack of documentation can all hinder the reimbursement process for your medical billing claims. Hospital coding techniques can vary greatly since so many individuals handle the coding and documentation and usually they require a good deal of overview. Medical billing for out patient and X-ray labs is usually very cut and dried to process as you only need to check the orders for necessity (especially for Medicare medical billing claims) and you need to make sure you have the proper documentation prior to submitting your medical billing claims. Asking for missing information in order …
What are Taxonomy Codes?
What are Taxonomy Codes? Even if you’ve only been involved in medical billing for a short time, you have seen taxonomy codes, they are primarily used in the billing of Medicare claims. The taxonomy code is now HIPAA mandatory and necessary for electronic filing of medical billing claims. The taxonomy is a unique alphanumeric code that is 10 characters in length. The code list is structured into three distinct “Levels” including Provider Type, Classification, and Area of Specialization. There is a listing called “The Provider Taxonomy Code List” which allows a single provider (individual, group, or institution) to identify their specialty by category. Providers may have one or more than …
Wound Length & Medical Billing Laceration Claims
Wound Length & Medical Billing Laceration Claims When processing medical billing claims for multiple laceration repairs – which is common when processing paperwork on an auto accident and many emergency room claims; normally you won’t add the repair lengths unless you have wounds that require exactly the same type and amount of care and are at roughly the same anatomic location as defined by CPT coding. The medical billing is easy enough to figure out on most multiple laceration claims. If there are different types of repairs you will use separate CPT codes on your medical billing. If you have multiple lacerations in the same area, CPT explains this by …
Ways To Up Your Menactra Reimbursements
Ways To Up Your Menactra Reimbursements As of July of this year there is an addition to the coding in the form of 90734 (Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 [tetravalent], for intramuscular use), and 3 insurance companies have a wide difference in reimbursements. Advance planning in your medical billing, proper patient coding, and exact documentation will help get your practice the ultimate reimbursement for this procedure. The average revenue reimbursement seems to be in the $85-$102 at this time from most carriers. Three different insurance companies were asked what their reimbursement rates would be for 90734 and received the following responses: United had not set a …
What billing methods put your practice at risk?
What billing methods put your practice at risk? There are several illegal medical billing practices that could get you charged for fraud or abuse. Millions and sometimes even billions of dollars each year is lost to fraudulent medical claims. Every one of us pays for it in some way or another. This article is meant to alert you of fraudulent medical billing practices so you can prevent them from happening in your practice. One common fraudulent medical billing practice is when services and procedures are billed for but were never provided. You may think, “How can a practice get away with this? Wouldn’t the patient know?” Since absolutely everything a …
How Is Medical Billing Generated?
How Is Medical Billing Generated? So, you’re not feeling well and you have tried all your home remedies and nothing is improving your illness, so you give in to go see your regular doctor. You go to the office and give them your insurance card and wait your turn to be called. Already you’re generating work for a lot of people and you don’t even know it. Your insurance card information is pulled up and a new medical billing form is created. No matter what procedures are rendered to you today, it will be documented in the form of numbers, called CPT codes, on your medical billing form. If you …
Using 92552 Correctly To Avoid Fraud Charges
Using 92552 Correctly To Avoid Fraud Charges Medical billing companies for audiology practices have long struggled over when to use the cpt codes 92552 versus 92551. 92551 means: screening test, pure tone, air only. 92552 means, pure tone audiometry (threshold); air only. You may be thinking, “What’s the difference?”. By definition, the difference between the two cpt codes is slight, but when medically billing these codes, it is huge. To avoid fraudulent charges, correct billing of 92552 is necessary. First we will begin with what it means to use 92551 in medical billing. Simply put, an audiologist places headphones on a patient. Then the doctor sets the machine at a …
