Archive for the Week of April 27, 2007
Archive for the Week of April 27, 2007
Welcome to the medical billing blog archive for the week of April 27, 2007.
Here you will find links to every article added to the Outsource Management Group web site during the week of April 27, 2007.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Reimbursements For Therapy Medical Billing
One of the biggest eyebrow raisers for carriers as far as medical billing claims go are any claim submitted for reimbursement for therapy based medical billing claims. Most therapy claims are 100% legitimate but because of the amount of fraud that has been perpetrated by a few unscrupulous individuals all of these types of claims get closer looks than ever. One way to insure your claims are submitted correctly is to make sure the documentation is done absolutely accurately in your therapy department. In a recent audit of claims, the CMS found that the number one error in reporting therapy medical billing claims is with the minutes billed. Make sure …
Don’t Make Mistakes On Admission Codes
As you know, a hospital admission requires face-to-face service. However a common dilemma that many medical billers find themselves in is when a surgeon “admits” the patient and then isn’t present when the patient arrives at the hospital to check in. In most cases the physician will dictate the history and physical (H&P) over the phone to the hospital and then send the patient over, however the dilemma for the medical billing occurs over the fact that the face-to-face interaction between physician and patient doesn’t occur until the following day. First of all, your dates must correspond. If the physician doesn’t see the patient in the hospital that day (performing …
Use Modifiers Carefully To Avoid Audits
If you commonly use modifier V57.1 (Other Physical Therapy) in your medical billing claims, be on the alert that the close scrutiny that started in 2006 will continue for your medical billing claims submitted. The reason for the close scrutiny is that some medical billing claims were submitted with medically unnecessary services actually done by the physician. This review started in Iowa and now is taking place in many states and will continue to do so until all states have been audited. Currently, the review will affect Part B Medicare patients only who are part of the outpatient home healthcare program. The reviewers will select home health outpatient claims with …
Using Modifier 51 With Lesion Removal
Lesion removals can be complex to report, however if you just break down the medical billing claim, you’ll find getting your filing points just right is a breeze. Your claim will usually start in the emergency room and remember that in almost all cases, the excision site before sending the patient home. If this closure represents a simple repair, the work involved is bundled into the lesion excision code you report on the claim. The other side of that type of claim however can be if the repair of the excision site gets more complicated, you’ll be able to report the closure as a separate procedure from the excision procedure. …
Laceration Medical Billing Claims Made Easy
Lacerations are a common occurrence in the ED and knowing the in’s and out’s of medical billing for these types of claims will make filing each and every single one of them a breeze. For example if you have a patient that presents who was using a table saw on the job and lacerated index and middle fingers on the palmar surface, but there is no significant bleeding and he is otherwise healthy. How would you report this? On further examination the physician finds on the pad of the distal phalanx of both involved fingers is a 1.5-cm laceration that is jagged with protruding fat. The notes read that the …
