Archive for the Week of April 14, 2006
Archive for the Week of April 14, 2006
Welcome to the medical billing blog archive for the week of April 14, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of April 14, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Modifier 51 Not to be Used by Hospitals
The multiple procedure code Modifier 51, causes some confusion among medical billing because it relates to multiple procedures performed but what many medical coders miss is the fact it only applies to multiple procedures performed by physicians and imaging centers. Carriers already assume during a hospital stay that multiple procedures will already be performed therefore designation of the exact nature and type of services rendered by the attending physician will still suffice for hospital medical billing claims. The CPT manual designates modifier 51 (Multiple procedures) exempt codes with a “circle with a slash” symbol to the left of the code. Pay close attention to those codes which don’t need modifier …
Have You Considered Medical Billing As Your Career?
Sometimes you feel you’re not in the right job or you have been out of the workforce and you’re ready to jump back in and you want some training that will benefit you, consider medical billing as a career. First of all, beware. There are some online services that will promise you a medical billing career and will charge you a large amount of money for a list of places to go obtain your learning from. This is a scam and don’t fall for it. There are legitimate places to get a good education in processing medical billing and it can be a profitable and rewarding career. In the 2005 …
Extended Office Hours Code Added
If you are a physician who keeps longer office hours or you have a 24-hour clinic, a new CPT code has been created to identify those services. The old coding method was to use 99050 when services were rendered by a physician outside of regular office hours but with more and more doctors and clinics extending their hours and 24-hour clinics becoming the norm, a code to designate those services rendered was needed. Now when a doctor provides care on evenings, Saturdays, and holidays; the code 99051 should be used to designate “”provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service.” …
The Controversy about 99058
In the latest revision for 2006, CPT has revised one code (99050) for after hours services performed by physicians and hospitals and added several more codes to designate specific times and places of services rendered. There is one code in the new listing, that is already causing some controversy as to when it is the proper time to use. It is 99058 and it is Schedule Disruption” due to an emergency situation. By the very nature of health care, there are many emergency situations and the code caused confusion from its debut. The AMA has amended the definition to mean that an emergency is defined by any event that disrupts …
About 99053 and 99058 for your Medical Billing
There are new codes issued in the CPT 2006 that specifically designate after hours and red-eye services for procedures done by physicians outside the normal hours. Previously when compiling the medical coding for medical billing, a coder would have used 99050 as a “catch-all” coding. Now CPT has revised the original code and added new codes. 99053 is ” “for services between 10 p.m. and 8 a.m. in 24-hour facilities,” and will be used by both physicians on call and hospitals. Please note that code 99053’s wording to include “24-hour facility” will put a new limitation on using late night service codes. Previously a coder would have simply used 99052 …
In the Beginning of Medical Billing: Medical Coding
Many people assume that medical billing and medical coding are one in the same procedure. However as you in the industry know, they are part of the same process, but very different. Medical coding is where medical billing begins and couldn’t be processed without it. When a physician or hospital renders services, a code is assigned to that procedure or procedures. The more services that are performed for a patient, the more medical billing codes there will be. Those codes are recorded on a medical billing form. The tricky part is keeping up with the ever-changing nature of the medical billing codes. These codes can be changed/added to/or removed many …
Correct Medical Billing for Foreign-Body Removal
Foreign body removal is another scenario that winds up with a lot of rejections or reduced reimbursements. One of the biggest reasons is that when the coding is being done on the claim. The part of the body affected isn’t addressed in the medical billing claim. If a foreign body was removed from a patient’s eye, then the code for simple foreign body removal should not be used. The specific coding for removal of conjunctival foreign bodies which is code 65205 (Removal of foreign body, external eye; conjunctival superficial) or 65210 (conjunctival embedded [includes concretions], subconjunctival, or scleral nonperforating). Notice that these codes do not refer to any particular instrument …
Medical Billing for Ob-Gyn Claims Made Easy
As you know, the CPT 2006 injection coding instructions now require that the ob-gyn’s presence be verified during an injection which is coded as 90772 or the procedure must be reported as a non nonphysician-performed procedure as 99211. The latter can result in a no-charge depending on the payer’s policies. You need to make sure you answer these questions: *Is the Doctor in the office and available at the time of injection?If you can answer yes, you can report this medical billing claim as 90772. If you cannot answer yes, then you have to use 99211 that is for injections given without direct physician supervision. The requirement does not mean …
Extensive Documentation for Chiropractors and Podiatrists
Medicare is recommending that chiropractors and podiatrists claims get extra-close scrutiny in their latest issue of the Red Book, which has recommendations for saving Medicare and other federally funded programs money. There will be more stringent requirements for chiropractors to meet for certain procedures and debridement services performed by podiatrists will be getting looked at very closely. If you perform these services or your are a medical billing company that does, check and double check your medical billing for the proper documentation before filing your claims to avoid delays in reimbursements or outright rejections of your medical billing claims. The modifiers used on these claims will be getting extra close …
