Archive for the Week of November 10, 2006
Archive for the Week of November 10, 2006
Welcome to the medical billing blog archive for the week of November 10, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of November 10, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Can NPP Services Be Reimbursed?
Absolutely, as long as the services meet the minimum criteria and you’re medical billing documentation is ironclad. If you aren’t getting a reimbursement for the services rendered to patients by a nonphysician practitioner (NPP) affiliate with your practice, you’re leaving money on the table for the insurance company that rightfully belongs to your practice. Learn the rules of the carrier and take the time to bill under the NPP provider number and statistics how that over three-fourths of the health plans billed would reimburse at an average rate of 85%. While this isn’t a full reimbursement, it is far better than not receiving anything in return for your services rendered. …
Better Reimbursements With Central Venous Access Billing
Make sure that you’re using the proper medical billing codes when reporting CVA services, if you’re not using CPT codes 76937 and 75998, you may not be getting the full reimbursement for this service. If a physician performs an ultrasound guided procedure, the code 76937 will give additional money for the procedure. This code means: ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent real-time ultrasound visualization of vascular needle entry. This means 76937 can be billed separately from the CVA placement code. One thing to note is that this code is only allowed one time per session in medical billing …
Busting the Pediatric Patient History Myth
Patient history, or PHI is an aspect of medical billing that has a myth attached. Contrary to popular belief, it is safe practice to allow any office member to take the review of systems and the family social history. These two evaluation and management history elements can actually be taken by absolutely anyone that is employed by the practice. It is ok in medical billing for even a parent or a secretary to take down this information as long as the information is reviewed and signed off on by the acting pediatrician. The only part of an evaluation and management visit that the physician or nurse practitioner must complete for …
Don’t Sweat "No Fever" Medical Billing
When a patient presents for emergency management services with various symptoms pertaining to the flu and no fever is found, you may be questioning exactly what should be noted in the medical necessity and other medical documentation sections of your medical billing form. You will not want to use this information under the history element. The 1997 “Documentation Guidelines for E/M Services” does not reference pertinent negatives in the context of the history of present illness (HPI). Instead, it references pertinent negatives in the context of the review of systems (ROS). Be certain not to check the associated signs and symptoms box of HPI. Instead, you should count the statement …
Understanding Locum Tenens for Your Medical Billing
Locum tenens is simply when one physician substitutes temporarily for another in the same capacity. There are some differences in billing for services performed by a locum tenens professional, however the 60-day time frame will apply. First and foremost, be sure you are appending modifiers Q5 (Service furnished by a substitute physician under a reciprocal billing arrangement) and Q6 (Service furnished by a locum tenens physician) as appropriate to use. The 60-day rule causes a lot of confusion. Basically, the clock starts ticking from the beginning of service and then runs for 60 consecutive days. It doesn’t matter whether the locum tenens or reciprocal billing physician provides services every day …
