Archive for the Week of July 21, 2006
Archive for the Week of July 21, 2006
Welcome to the medical billing blog archive for the week of July 21, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of July 21, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Sutures-Get Your Reimbursements
If you have had V58.3 denials in the recent past, it’s probably due to your method of reporting the procedure on your superbill instead of an unnecessary procedure. Make sure that you report V58.3 as a two-line entry. Instead of “dressing change/suture removal”. Additionally, the coming ICD-9 2007 changes that will go into effect on October 1st will also have more specifics for reporting in this series. This will include three aftercare types. Remember that V58.3 is no longer a catchall coding for these procedures. The new codings will be as follows: * Nonsurgical wound dressing change or removal–V58.30 * Surgical wound dressing change or removal–V58.31 * Suture removal–V58.32. Payers …
Correctly Using Modifier 59
Modifiers can be a helpful addition to medical billing. However, there are certain modifiers that are constantly used incorrectly. The contractors for the Centers for Medicare and Medicaid Services are now keeping an eye out for suspicious modifiers. The medical billing modifier 59 is on the list of modifiers to flag for review. Recently, the U.S. Office of Inspector General released a report that showed some daunting medical billing news. Modifier 59 has been the cause of over $59 million in overpayments to nursing homes and providers. Due this large number of overpayments, Medicare contractors will be closely scrutinizing each medical billing submission that contains the modifier 59. To prevent …
Correct Medical Billing for Family Meetings
If you have a meeting with the family members of an assisted living facility patient (patient was not present) to discuss any aspect of the individual’s healthy status, such as memory loss or personality changes, you can bill Medicare but this scenario would not qualify for CPO (Care Plan Oversight) services. Instead this would fall under the realm of code range 99324-99337,(Domiciliary or rest home visit for the evaluation and management of a … patient). By the way, when you do report CPO services for a private-pay assisted living facility patient in the near future, you would assign new 2007 codes 99339-99340 (Individual physician supervision of a patient [patient not …
Correct Usage of 99336
Rest home care medical billing can be very tricky. Many coders bill for at home services or nursing home services when rest home care is performed. Incorrect medical billing coding such as this, could get you into trouble. Make sure your staff is up to date on the new medical billing coding regulations that addresses the specific guidelines for rest home coding. The place of the service is a big issue when dealing with the rest home services. Rest home, or custodial care facility is labeled as a POS 33. This is defined as a facility that provides room, board and other personal assistance services generally on a long-term basis. …
Using 92630
Aural Rehabilitation has caused a lot of confusion regarding how to do the medical billing correctly for the best reimbursements. Additionally, medical billing changes to Aural Rehab CPT codes have incorrectly caused many people to believe Aural Rehabilitation is not covered. Medicare actually assigned status code “I” to all new medical billing codes for auditory rehabilitation. These codes are 92630 and 92633. This means that the Centers for Medicare and Medicaid Services will not pay for auditory rehabilitation, only diagnostic audiology. However, this is only true if an audiologist performs the service and the medical billing. There are several other medical professionals that could possibly perform medical billing for aural …
Bigger Reimbursements for 92626
Medical billing in the speech, language, and hearing community is looking a little more lucrative. A transmittal released by the Centers for Medicare and Medicaid Services announced a dramatic increase for reimbursement for the Current procedural terminology code 92626. Medical billing reimbursement will be nearly four times the old amount for this code. The current procedural terminology code 92626 (Evaluation of auditory rehabilitation status; first hour) was reimbursable at $22.07. This has changed. Medical billing now allows this code to be valued at $81.76. The relative value unit (RVU) used to calculate this medical billing reimbursement was 2.20. Originally the RVU was 0.55. The American Speech Language Hearing Association (ASHA) …
Get Better Reimbursements with 77470
There are some cases when certain medical billing practices can get your office more financial reimbursement. The use of the current procedural terminology code 77470 is one of those instances. This code, however, cannot be used all of the time. There are certain things you must keep in mind before using the medical billing code 77470 for your claims. Sometimes the physicians in your clinic can see patients with special needs. For instance, an oncologist may see a patient that has a pacemaker. The pacemaker can make visits and treatment plans more time consuming for the physician. In this instance, the medical billing code 77470 may be used. 77470 in …
Split Out Your Coding for Chronic Kidney Disease
There have been some ICD-9 coding changes for chronic kidney disease (CKD) medical billing. In mid-2006, CMS revamped the CKD diagnosis coding section and now, if your practice treats a patient that suffers from CKD, you will need to use one of the stage specific codings the 585.1-585.5 series. Here are the CKD diagnosis codes that CMS wants you to use in 2006: * 585.1–Chronic kidney disease, stage I. Use this code for patients who have kidney damage with normal or increased glomerular filtration rate (GFR), greater than or equal to 90 ml/min/1.73m. * 585.2–… stage II (mild). This code represents kidney damage with mild decrease in GFR, 60-89 ml/min/1.73m. …
Getting Your Medical Billing Claims Paid
If your medical billing forms don’t have the proper diagnosis codes listed on your billings that are submitted to Medicare & Medicaid Services, the claim can be rejected. Any claim without a valid diagnosis code will not be processed. In previous years, when claims came in from service providers with incorrect diagnosis codings, the Medicare carriers would make the proper corrections and then reimburse the medical billing claim. Medicare personnel will no longer perform that function. Absolute correct coding is now required in order to reimburse for Medicare Part B services. A lot of service providers used to rely on this correction by the personnel at Medicare. As this is …
Are You Using Modifier 22?
In the world of medical billing, modifiers can be just as important as the CPT codes they append. A simple mistake such as miss sequencing these codes could lead to incorrect reimbursements. There is one modifier that is known as being the most incorrectly used modifier: 22. Knowing how to correctly use the medical billing modifier 22 is an important skill to learn. Modifier 22 (Unusual procedural services) is used to indicate a substantial amount of extra work a physician needs to do for a specific procedure. As a matter of fact, there are some procedures that never get separately reimbursed unless modifier 22 is used in medical billing. The …
