Archive for The Month of June, 2006
Archive for the Month of June, 2006
Welcome to the medical billing blog archive for the month of June, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the month of June, 2006.
You can browse this month's archives by clicking the "More" button from any of the excerpts below.
Auditory Rehabilitation Receiving Medical Billing Reimbursement
The Centers for Medicare and Medicaid Services have recently made it known that the reimbursement for procedural code 92626 is going to be seeing increases by a rather large amount. To clarify a little bit further, the reimbursement to providers for such a procedure will come in at approximately four times the amount being received currently. This should make any of the providers of language, speech and hearing much happier when it comes to medical billing. This entire thought of reimbursement may be a lot clearer if it is broken down a bit. For example, the code 92626 which is known for the description of Evaluation of Auditory Rehabilitation Status; …
Tightening the Reigns on Medical Billing Claims
It has recently come to the attention of the Cahaba GBA Regional Home Health Intermediary that it is necessary to tighten the reigns on medical billing claims. Therefore, a study has been underway to try to find out exactly why certain claims have been denied. Through the course of this study, there have been a good number of findings to show that there have been denials of various diagnosis codes within the medical billing process. Further studies by the Cahaba GBA have revealed that a large amount of the denied claims had actually shared the same diagnosis codes. Included in the list of diagnosis codes that are often denied are: …
Medical Billing Modifier 59 Has Been Causing Trouble
Recently, the contractors for the Centers for Medicare and Medicaid Services have been on the lookout for any modifiers that have been used incorrectly. The cause for alarm is that it has recently been shown that even though modifiers are a great asset to medical billing, there are a select few modifiers that are not used in the proper fashion. Of all of the modifiers that have been used incorrectly from time to time, the one that has seemed to have been the most questionable is modifier 59. Now, this is not just any random investigation just because there have been a few problems. Studies by the U.S. Office of …
Getting Rid Of Denial Claims For Well Visits
You should always pay good attention to what payers are perceiving when looking at your medical billing. Even though your practice may view the coding procedures a certain way, it is not always the case that your payer will understand them in the same fashion. It has recently been shown that there is a major discrepancy when it comes to dealing with the billing of the procedure code 96110. The fact is that this procedure code should never be lumped in with well exam codes, except for special circumstances. What can actually happen to cause problems is that the miscommunication between medical billing for your practice and the payers are …
Always Appeal Your Denied Medical Billing Claim
It is a well known fact that everyone is human and we are all prone to make mistakes from time to time. Often times, your medical billing personnel could end up miscoding an item just because they are not up on all of the latest rules regarding ICD-9-CM or CPT rules. Because of the chances for a miscoded item being so high, it is always important that you know how an appeal can help you when your medical billing claims get denied. You may already know this, but there are a good deal of practices that will actually lose a good deal of money every single year because they do …
Double Check Those Medical Billing Adjustments!
Your staff may be grumbling about the M0175 medical billing adjustments. The Centers for Medicare & Medicaid Services announced that all home health intermediaries are required to post their adjustments however the new adjustments were delayed in posting to the United Government web site and the CMS delayed the implementation of the adjustments. Your medical billing staff needs to check the website frequently to make sure you’re getting all the adjustments that are due, if you miss filing on an adjustment, you are literally throwing away money. If your in-house staff is overworked and having a hard time keeping up with the changes, new codes, deleted codes and the filing …
PHI – Is Yours Safe?
Billing and reimbursements are the life’s blood of any practice. They keep the offices up and running. Without proper claims submissions and payments, there would be no money to run the practice. PHI is a big element when submitting claims. Keeping PHI safe is important for your patients’ safety and the longevity of your practice. PHI information is confidential information that only your patient, you, and covered entities should have access to. This medical billing PHI would include a patient’s social security number, diagnosis, treatment plan, medical history, and other personal and pertinent information. Since the content of your medical billing claims is so sensitive, it is important to always …
Correctly Using POS Codes in Your Medical Billing
More and more carriers are cracking down on medical billing claims that have a lack of or incorrect place of service code. Even with the correct current procedural terminology code for E/M services, a medical billing claim that does not have a correct POS code will get your claim denied. It is a common occurrence in medical billing for the place of service codes to be misused or left out. There are several current procedural terminology codes for an evaluation and management session that correspond to different medical billing place of service codes. When using CPT 99341 (Home visit for the evaluation and management of a new patient) through 99350 …
Magical Modifier 25
Modifier 25 is a medical billing code used to indicate extra work for a medical service or procedure. There are three simple steps you can use to learn how to correctly use the medical billing modifier 25. The first medical billing step to correctly use modifier 25 is to only report the most significant services provided during the visit. When reporting an Evaluation and Management exam, it is very difficult to perform a service that is separately billable. Most things are covered under the evaluation and management, including injections and tests. In order to correctly append the medical billing modifier to a procedure, it must be very significant. The next …
Proper Usage of Code 58679
Even with the reams of information and thousands of codes, there are many procedures in which there is no particular medical billing code to represent it. For instance, an Oophoropexy is usually performed for radiation therapy, but what if it were part of a treatment for polycentric ovarian syndrome? In the oophoropexy example above, some medical billing staff members may use the current procedural terminology code 58825 (Transposition, ovary). Unfortunately, they would be incorrect and would receive most likely a very reduced reimbursement or an outright denial of the medical billing claim. The definition of transposition is when an ovary is moved due to radiation therapy. Since radiation therapy is …
