Archive for the Week of July 28, 2006
Archive for the Week of July 28, 2006
Welcome to the medical billing blog archive for the week of July 28, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of July 28, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Undercoding Your Medical Billing Can Cost Your Practice
A well-known secret in the medical billing industry is that many physicians purposefully undercode because they are fearful of the penalties for overcoding or unbundling their medical billing claims. Another big mistake some physicians make is to leave their coding to their staff, which is guaranteed to have errors because the staff has no way of knowing exactly which services occurred in the exam room and which did not. In capitated care issues, physicians who don’t code for supplies reimbursement on their medical billing claims lose a lot of money. Imagine if every patient that you provided services to was worth an extra $50, imagine how that revenue would add …
Get Reimbursed for Tests
Diagnostic testing causes a lot of confusion in medical billing. One rule of thumb when doing the billing is to only report what your documentation will support. It is tempting to report a diagnosis that comes after a pathology test because common sense would tell you that it is more likely to be paid. Instead report the reason for test and use your medical necessity such as patient complaints and symptoms to back up the reasons for the test. Use your judgment when reporting testing and don’t use presumed diagnosis where an illness or condition is trying to be “ruled out”. Instead code the signs and symptoms the patient is …
Coding Dual Procedures
If you have a core biopsy and an FNA (Fine Needle Aspiration) performed on the same day, your CMS manual states you cannot report fine needle aspiration (FNA) codes 10021 and 10022 with another biopsy procedure code for the same lesion. A good example of this is when a physician performs an FNA and core biopsy for the same breast lesion during the same encounter, but does not document that the FNA sample was inadequate for diagnosis. The physician performed the services described by 10022 (Fine needle aspiration; with imaging guidance), 19102 (Biopsy of breast; percutan-eous, needle core, using imaging guidance), and 76096 (Mammographic guidance for needle placement, breast [e.g., …
The Importance of DME Preapproval
Durable Medical Equipment refers to wheel chairs, braces, shower chairs and other assisted living equipment. And are generally purchased as an outpatient. It really does not matter if your patients are insured through Medicare, Medicaid, Workers’ Compensation or through a private insurance carrier, nearly all DME claims must be preapproved prior to submission of the medical billing claims. Many of these policies have strict guidelines that must be followed in order for the DME medical billing claim to be paid. Some providers will require that the DME be purchased through their own sources and have a listing of specified providers. Many HMOs are very narrow about the DME they will …
The Trickiness Coding Radiology Services
Medical coding for radiology services can be very tricky. Most radiology procedures, unless emergency, normally need pre-approvals in order to receive reimbursement for services rendered. Failure to get a pre-approval can result in your medical billing claims for radiology being denied and rejected. Make sure you have a pre-approval on file before the services are rendered. Contact the carrier, note the date and time that you called. Get the first and last name of whoever approves the services. You may very well need this information in the future if your medical billing claim is denied. There are also CPT coding changes that happen often in the field of radiology. Keeping …
Choosing A Medical Billing Company
Deciding to outsource your medical billing is not a decision to be taken lightly, and in the beginning you may not even need to outsource your billing in the beginning. But soon, you will find that your staff is so busy servicing your patients and running your office with its day-to-day goings on, finally you have to look at outsourcing. There have been some horror stories out there about physicians outsourcing their medical billing or practice management to a company and then finding out it cost them even more money because the company just wasn’t up to date on their coding books or simply not experienced enough to handle the …
How is Auditory Rehabilitation Billed?
Medical billing changes occur each and every year in America. 2006 has brought many changes to the forefront. Aural Rehabilitation is one major area of confusion. Medical billing changes to Aural Rehab CPT codes have wrongly 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 …
Is Outsourcing Your Medical Billing Claims Secure?
In a word, absolutely. There are a lot of pros to outsourcing your medical billing. Don’t let confidentiality concerns stop you from outsourcing your medical billing. A reputable firm will provide a confidentiality agreement and rest assured your records are handled with the utmost care. Confidentiality and accuracy are part of a billing company’s standard business practice. Your practice will benefit from outsourcing because with the burden of medical billing handled outside your office, you and your staff will have more time to run your business. It will allow you time to develop relationships with new patients and more time for marketing your practice. Using an outside firm to handle …
Look Into Separating Payments on Separate Tests Performed
Did you know that you can actually bill separate tests performed from your practice for separate payments? Certain practices have been taking advantage of larger reimbursements by doing just that. Say that you have a patient that is new to your practice and they are coming in for an exam. You can both bill for that exam and then bill separate for any other tests or screenings that they will be having performed. Although you may feel as though you are doing something wrong when it comes to medical billing practices such as these, but the Centers for Medicare and Medicaid services have been doing a good amount of research …
