Archive for the Week of April 5, 2007
Archive for the Week of April 5, 2007
Welcome to the medical billing blog archive for the week of April 5, 2007.
Here you will find links to every article added to the Outsource Management Group web site during the week of April 5, 2007.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Understanding Review of Systems In Your Medical Billing
Combining history of present illness and review of systems is possible when doing medical billing. Many medical billers think this practice is breaking a rule or impossible. However, documenting an element once to account for HPI and ROS is perfectly legal when done correctly. The CMS states that physicians absolutely do not need to document an element two times just so the person performing medical billing knows it is meant to be used both for review of systems and history of present illness. It is perfectly acceptable to use an element for both. The only time an element cannot be used twice is when you attempt to use it in …
Medical Necessity Can Make or Break Your Claim
Along with documentation, medical necessity is one of the most important parts of medical billing. You tell exactly how the procedure was performed, be sure to meet the criteria for medical necessity of the procedure by telling why the procedure needed to be performed. It used to be that Medicare was the only payer that cared what ICD-9 code was used. Now all payers, including insurance companies, are looking for any reason not to pay the bill or at least delay it. ICD-9 codes have become the target for close scrutiny. ICD-9 codes range anywhere from a three-digit code to a five-digit code. Obviously, a five digit code is more …
Coding for Oxygen Administration
Coding a medical billing claim for oxygen administration can be a tricky beast because there is not a specific oxygen administration code assigned. Normally the administration of oxygen is bundled into an emergency visit. When a doctor prescribes the oxygen, you should use the appropriate office visit code that describes the procedure and services performed by the physicians that necessitates the need for oxygen. Full documentation of the medical billing claim will insure that your bundled oxygen administrations codings get full reimbursement. For example if you have a physician who performs a detailed examination on a patient and decides to administer oxygen to a known patient who is in the …
Breaking Down a Breast Biopsy
Here is a perplexing problem. When a surgeon meets with a patient an recommends a breast biopsy, we report a consult for this particular visit. On the day of the biopsy procedure, the surgeon will re-examine the patient, answer questions, an so on. The time that is spent prior to the procedure is ten minutes. In a case like this, you will not report a separate E/M with the biopsy. It is important to remember that all procedures include an inherent E/M component, according to CPT and CMS guidelines. In order to qualify as a separately billable service, any E/M the physician provides must be both signifigant and separately identifiable …
