Archive for the Week of September 22, 2006
Archive for the Week of September 22, 2006
Welcome to the medical billing blog archive for the week of September 22, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of September 22, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Common Medical Billing Coding Confusion
A common confusing coding dilemma concerns the diagnostic investigation of the swallowing function with a few different methods. The two codes that cause the most confusion are 70371 and 74230 and knowing when to use them will make the difference between a paid medical billing claim and a denial or delayed claim. Here is a breakdown of the basics for the two codes : 70371: Code 70371 (Complex dynamic pharyngeal and speech evaluation by cineradiography or video recording) describes a radiologic study using cineradiography or video recording for pharyngeal and speech evaluation. Typically, although not necessarily, a speech pathologist is present, and the patient repeats sounds to allow for evaluation …
Perinatal Billing Code Additions Coming Soon
Head’s up! There are ICD-9 code additions that will most likely impact OB/GYN’s. They haven’t been solidified yet, but here’s a sneak peak at what could be included in the coming changes. These codes are slated to be four new ICD-9 code changes that will become available in October. The four new codes will be in the perinatal sector of care and are : * 768.7 new code for hypoxia and birth asphyxia — , Hypoxic-ischemic encephalopathy (HIE)* two new codes describing other respiratory problems after birth:* 770.87 — Respiratory arrest of newborn* 770.88 — Hypoxemia of newborn Another slated change may be the addition of a fifth-digit subclassification under …
How to Avoid Fraud and Abuse Charges In Your Medical Billing
Gainsharing in medical billing is highly scrutinized. The HHC Office of Inspector General is very suspicious about gainsharing activities with healthcare providers. There are three areas hospital providers should focus on in order to prevent medical billing fraud allegations. Improper gainsharing agreements are borderline fraud in medical billings. The three things hospitals can do to prevent any fraud charges are having sufficient quality controls implemented, promoting accountability, and limiting payments that lead to referral pattern changes. If all three of these elements are satisfied, your hospital will have no problem providing trustworthy medical billing. In order to run a hospital successfully, two things are necessary: quality of care, and profitability. …
Bulletproof Your Medical Billing Claims
Documentation is the Kevlar jacket for the medical billing industry. When you’re compiling your medical billing claim make sure that your documentation is detailed and exact in nature. Never submit a medical billing claim without documentation as it will only deny or delay your reimbursement on your claim. A good example is if a patient presents in an ED twice in one day. Generally most carriers will deny a medical billing claim showing duplicate visits. However if medical documentation shows the necessity of those visits were for two different services such as a critical care code (99291-99292) or reports prolonged care (99354-99355) in addition to the E/M code, the carrier …
9-Day Delay May Turn Into 12 Days
No doubt you’ve heard about Medicare holding all claims from Sept. 22 through Sept. 30, as required by the Medicare Modernization Act. The Centers for Medicare & Medicaid Services had claimed that all of those claims would be paid promptly on Oct. 2. But now it turns out that may not be strictly true. Some larger carriers have reported they may have been notified that there may be a delay in mailing out checks, so this may turn into a 12 day holding. Make sure your office staff knows about the September delays in medical billing so they don’t waste time tracking claims. Additionally, make sure on your Medicare claims, …
