Archive for the Week of December 29, 2006
Archive for the Week of December 29, 2006
Welcome to the medical billing blog archive for the week of December 29, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of December 29, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
A Good Solution for Colonoscopy Confusion
There has been growing confusion over exactly how to report the growing number of colonoscopies that become “diagnostic”. This procedure has become more and more commonplace and the debate continues. Sometimes the best answer is the most obvious, contact the carrier and ask them how they want the procedure reported on your medical billing. Colonoscopies are part of a check up for most individuals over the age of 50, however when the colonscopy finds a polyp, you should normally use the polyp diagnosis in your medical billing claim and not the screening V code. The exception to this rule would be if the physician discovers a polyp during the screening, …
Interesting Study About Doctor’s Charges
A recent study came up with a staggering conclusion, nearly three-fourths of U.S. consumers said they know little to nothing about how the fees of their doctors compared to other physicians in a similar practice. Furthermore the study concluded the most Americans actually underestimate what their providers charge. For example, most adults (65 percent) think that, in general, a high-priced doctor in the U.S. charges two or three times as much for the same procedure as a low-priced doctor. In fact, a review of HealthMarkets data for several selected procedures shows that some doctors charge nearly 10 times what others charge for the same procedure. Additional information gained in the …
Noting When Radiation Therapy Is Twice Daily?
The opinion released by The Centers for Medicare & Medicaid Services (CMS) has said you can bill for twice-daily radiation therapy as long as the treatments happened in “different sessions.” But you have to be careful to follow the rules and avoid getting into trouble by billing for “different sessions” that were really just parts of the same session. A procedure called “hyperfractionation” is defined as any technique of radiation treatment that delivers more than one treatment session per day. If you’re stumped how to make sure that a session is separate from another session, just know this: to be considered separate, two sessions should be at least six hours …
Medical Billing for Tissue Adhesives
One point that many medical billers find confusing is the correct procedure for coding the use of tissue adhesives when used for wound closures. The answer to this question will be different depending on which entity is paying the medical billing claim. When you code for the use of tissue adhesives, including Dermabond; Medicare has its own guidelines for reporting this procedure that you need to follow to be reimbursed. You should report G0168 for Medicare patients only. If you are reporting the procedure for a non-Medicare patient, you should use the CPT code that is the equivalent and that is 12001-12018 series (Simple repair of superficial wounds …). Another …
Medical Billing Claims for Tests That Are Normal
If you have a medical billing claim to file and the test that was performed on the patient comes back without any definite diagnosis, don’t discount the fact that you won’t be reimbursed for the medical billing, instead you need to determine whether the test result is normal, negative, or inconclusive and that final reading will determine how your medical billing claim should be handled. If your test comes back inconclusive, you shouldn’t report a diagnosis that the laboratory gives you after a pathology test. Many practices mistakenly report the lab’s diagnosis because they feel that claim will legitimately get paid. A good rule of thumb is to code the …
