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.
Been Hit With Medically Unlikely Edits Denials?
It can happen to any individual who is involved with coding, dealing with MUEs can end up being a nightmare if you do not know when and how to use them. MUEs, which is short for the term Medically Unlikely Edits, happen to be put in place to try and help limit the amount of billing errors. The more you understand them, the better off you will be when you find that you need to use them. If you are worried about dealing with MUEs, then you really should know that you are not alone. Luckily, there are a couple of things that you can look to and keep in …
Medial Dislocation – Billing it Right
A common occurrence in the emergency is the dislocation of various joints. They are sometimes incorrectly handled as breaks but shouldn’t be and you could be setting your practice up for a denial at best and audit at worst if you report these procedures incorrectly on your medical billing. Even if the reduction of the dislocation fails, the attempt should be reported on not only the medical billing as a procedure but also in the documentation as another procedure will have to be tried to relocate the elbow to its proper placement and you can show the timeline for the necessity of other and more involved treatments. On the claim …
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 …
Oh, Those Feelings of Rejection!
When your medical billing claims get rejected, one claim can put your staff behind on everything they are supposed to be doing. The patient’s folder will have to be pulled, the notes will have to be re-read and researched, the claim will have to be compiled again and the coding will need to be double checked again to make sure you are using the latest codings and modifiers for the claim. In some cases the carrier will need to be contacted which is more time lost from servicing your practice and the claim will have to be submitted once again and the will take more time away from your day …
How Can An Outside Audit Help Your Practice?
No one likes the word “audit” but sometimes it can help your practice. When it’s coming from the IRS or other authority office, an audit can be a major stressor; when you enlist the services of a third party partner to do an audit on the way your medical billing is filed – there are no penalties – only pluses! An internal audit of the way your medical coding and billing is handled can alert you to problems you may not have even been aware existed. Staff members can be adverse to change and continue using coding combinations that do not result in the maximum reimbursement for your services. When …
Office Visits And Well Checks
Any time you are coding for problem visits that a patient has, it is important that you take into consideration any other office visits that they may have recently had. Basically, you are going to want to look to see if there is a connection between visits for preventative medicine as well as current health issues that may be in place, which also needs some attention. Many times, a physician will end up seeing a patient that shows up in search of a visit to fall into the category of preventative medicine. Then, upon further evaluation, the doctor will then need to look at the patient further for some sort …
Keep Your Observation Coding In Check
There is nothing worse than finding different coding mistakes. One of the things that you can do in order to keep certain mistakes from showing up is keep your observation coding in check. Although you may think that you know all of the general rules in terms of observation services reporting in the ED, mistakes can still happen. When you are looking to smooth out any of the wrinkles found in your observation coding, you can keep several things in mind. For starters, it is very important that you do not bill more than once for physicians that are from the same group. This is a situation that calls for …
In Medical Billing, Partners are Valuable Assets
Did you know your medical billing partner can be counted among your most valuable business assets? Customer service and health care are also very important aspects of your practice, however, medical billing is the core of the business. You should know at all times that people responsible for the core of your business can be trusted. Knowing your medical billing staff members is imperative to your success. Medical coding and billing is an extremely skilled practice. When you outsource your medical billing claims, you have to have confidence that your medical billing partner will check the coding, put the medical documentation in order, make notations where needed and submit your …
Get Up To Date On Your Q Modifiers for Foot Care
More Q Modifiers were updated recently, make sure that your staff is up to date on the currently preferred to be reported when the physician is performing foot care. Modifiers Q7 (One class A finding), Q8 (Two class B findings) or Q9 (One class B and two class C findings) tell insurers why your physician is performing foot care. To determine which modifier applies to your physician’s claim, check out the following list of what Medicare and other payers include in each description: Class A Finding:Nontraumatic amputation of foot or integral skeletal portion thereof Class B Findings:Absent posterior tibial pulseAdvanced trophic changes such as (three of the following sub-categories qualify …
Free Up Your Staff By Outsourcing
If you are finding that you’re chasing medical billing claims and having a lot of rejections, it may not be your staff, it might be that they are unable to keep up with the fast pace of the ever-changing medical billing industry. It might be time to consider outsourcing your medical billing claims. And you can get a lot more than just have your medical billing claims handled. We can provide a complete medical billing service for your practice. It will include filing both your electronic and paper claims along with any necessary consulting. We also offer comprehensive medical coding services. This includes analysis of your claims, coding audits and …
