Medical Billing Blog: Section - Audit
Archive of all Articles in the Audit Section
This is the archive containing links to all articles written in the Audit section of our blog.
Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.
Taking the Headache Out of Credentialing
Are you swamped? So overwhelmed with patients, billing, invoices, emergencies and other day to day practice worries that you don’t even have the time to get yourself credentialed with all the carriers possible. No one has to tell you that the more insurances you accept, the more patients you can see and the more revenue you can generate for your practice. Credentialing is the key. Did you know your medical billing partner can take some of the heat off you and not only compile and submit your medical billing, they can also get your practice credentialed with any carrier you choose. If you have a busy practice, you may be …
Getting the Indirect Supervision Code Right in Three Steps
For help with performing the care plan oversight services if you are having a hard time with the 993xx series these steps should help to get you started. Step one is to count these care services as 99374-99380. The 993xx series codes allows pediatricians to bill for coordination of care of special needs children without face to face visits. You can report these care plan oversight CPO codes as 99374-99380 for Doctor supervision. This is only for when the patient is not present for the following doctors services, a) revision or development of care plans for multidisciplinary and complex modalities. b) related lab and other studes review c) patient status …
434.91 – Stroke – Hemorrhage or Both?
When using 434.91 make sure you take all of the specifics into account. When a doctor says that a patient has had a stroke make sure that you know all of the details of the situation or else some procedures can be hard to justify and therefore your medical billing reimbursement may be denied. In the past for diagnosis of a stroke the ICD-9 index listed 436, which is acute but ill defined cerebrovascular disease, as the code to use. Now the index has code 434.91 as the code to use. This is cerebral artery occlusion, unspecified with cerebral infarction. The new ICD-9 index automatically translates a doctors diagnosis of …
Get Better Reimbursements on Common ER Procedures
Knowing when to use code 90782 in emergency department procedures can help with your medical billing reimbursements. For example, if a doctor examines a patient in the ED for an injury, and injects a preventative tetanus toxoid, your first instinct might be to use 90782 as a modifier for this procedure. But you would not receive a medical billing reimbursement because the incident to provision does not apply in the emergency department so you would not be able to justify having the doctor administer this injection. There would be no way to justify the medical necessity of such a shot. However, when you are in an office setting the CPT …
ICD-9 Updates Coming October 1, 2007
Are you ready for the updates coming on October 1? There are a number of changes that will affect that way Medicare reimburses your practice for the services rendered as well as adding and retiring other codings. All of these changes will be effective for service dates after October 1. You can avoid a lot of paperwork hassles and denials by making the jump to outsourcing your medical billing. Your third party partner will keep up with the ICD-9 coding changes, rules and regulations and if you choose, can even do an audit of your current medical billing methods and show you how you can realize a better reimbursement rate …
When to Use 90782
Knowing when to use code 90782 in emergency department procedures can help with your medical billing reimbursements. For example, if a doctor examines a patient in the ED for an injury, and injects a preventative tetanus toxoid, your first instinct might be to use 90782 as a modifier for this procedure. But you would not receive a medical billing reimbursement because the incident to provision does not apply in the emergency department so you would not be able to justify having the doctor administer this injection. There would be no way to justify the medical necessity of such a shot. However, when you are in an office setting the CPT …
Aural Rehab Not Reimbursed?
Medical billing changes occur throughout each and every year and keeping up with those changes can be confusing. Aural Rehabilitation has become one major area of confusion since the 2006 update. The medical billing changes to Aural Rehab CPT codes has wrongly caused many people to believe Aural Rehabilitation is no longer a reimbursable service. Medicare actually assigned status code “I” to all new medical billing codes for auditory rehabilitation. These codes are 92630 and 92633. This means that the Centers for Medicare and Medicaid Services will not pay for auditory rehabilitation, only diagnostic audiology. However, this is only true if an audiologist performs the service and the medical billing. …
Gastric Bypass Codings Becoming More Common
As a medical biller, you may be seeing an increase in the number of gastric bypass claims that you are handling as more and more insurances are covering this procedure as a measure to remove the patient from danger of developing more serious, chronic and costly illnesses that can stem from being grossly obese. After a patient has undergone gastric bypass surgery, eventually they will have the band removed. Many medical billing professionals are amiss at whether to include modifier 59 with their claim in order to obtain reimbursement for the procedure. Under The Correct Coding Initiative (CCI), normally the procedure of removing the band and port removal would be …
Can Your Practice Benefit From the Auditory Rehabilitation Boost?
The Centers for Medicare and Medicaid Services have recently made it known that the reimbursement for procedural code 92696 is going to be 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; first …
The Sensitive Issue of Handling Hard Copies
A question that comes up often is exactly how should a medical practice dispose of the hard copies of files? The answer isn’t rocket science, shredding is the only good answer. When you are ready to dispose of hard copies medical files, anything with a patient’s name on it should be shredded. If you don’t have the staff available and you don’t want to invest in an industrial-sized shredder, a good alternative would be to hire an outside shredding service that will either come to your offices and shred on site; or pick up your files, lock and store them in sealed containers and put them on a closed end …
