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.
Can Medical Billing Services Benefit Your Practice?
Feeling stretched too thinly? If so you will find our medical billing services can help you tremendously and it doesn’t matter if you’re located within Indiana or outside the state, we can handle medical billing claims nationwide. When you decide you’d like to use our medical billing services, we know that each provide and practice is completely individual in their needs and we will consult with your to find out what your concerns are regarding your billing. We will set your office up to communicate your medical billing claims via secure transmission to our office. If you’re interested in the rest of our Medical Billing Services we can also do …
Medical Billing Dilemma – POS Codes
For correct payment amount, accurate place of service codes are required. The failure to provide the correct place of service code with the correct current procedural terminology code for E/M services will cause your claim to get denied. One of the most important elements of medical billing is the place of service code. In medical billing, the place of service codes for an evaluation and management are commonly misused. 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 (which …
Hiring a Medical Billing Consultant?
It’s hard to let go of what you might deem the financial control of your practice. Hiring a medical billing consultant can seem like you’re adding expenses instead of cutting them down, especially if you have never outsourced your billing. If you’ve always discounted outsourcing your medical billing claims because you feel as though you would be relinquishing control over your billing, read on – you’ll find that is not the case. Actually outsourcing your medical billing and coding needs through a consultant is one of the smartest business moves you can make. Don’t think you have to use a local company, many medical billing firms have branch offices in …
Keeping Up With Medical Billing Changes
January 2007 brought more changes to the medical billing industry. Certain codes were “retired”, new codes were added and others simply had their meanings broadened to encompass their meanings. If your practice doesn’t keep up with the changes and know in advance of coming changes, you can be losing out on legitimate revenue for services rendered. Some practices are losing up to one fourth of their revenue simply because they staff isn’t aware of the best techniques for reporting procedures. Undercoding is another way many practices don’t get the full value for their services. If your staff is undercoding your medical billing claims you are definitely missing out on reimbursements. …
Medical Billing To Differentiate Between Facial and Dental Nerve Blocks
When you have a procedure that can cover two close but distinctly different areas such as a facial and a dental nerve block, you need to make sure that your claim encompasses exactly the procedure that was done or you may wind up with a denial of your claim. A common situation would be if the ED physician performed a diagnostic nerve block on a patient complaining of pain in the floor of her mouth and her bottom set of teeth. You would want to be certain that you chose 64402 (Injection, anesthetic agent; facial nerve) for facial nerve blocks, not blocks in the mouth or jaw. The determining factor …
What About Modifier Q6?
Remember when medical billing used to be a simple affair of matching the procedure done with a couple of medical billing codes to describe what was done, attaching your documentation and then submitting your medical billing claim for reimbursement? Now we have codes for codes and modifiers and the need to when to bundle and when to not bundle with the goal being fair reimbursement for procedures done. Modifiers cause a lot of confusion for many medical billers. One such confusing modifier that is worth clarifying is Q6. This applies to Medicare medical billing claims only, but in a nutshell when one of your staff physicians takes a leave of …
Correct Coding for Long Term Care Medical Billing Claims
Long term care medical billing has it’s own set of nuances that must be followed in order to ensure that you receive proper reimbursements for the services you provide. Since nearly every patient you treat will have a long term history of care – it’s sometimes tempting to skimp on the medical documentation and necessity but since you have no way of knowing who is going to review your claim, you need to handle every claim as a fully individual manner complete with full documentation or you may wind up with partially paid claims or outright denials of your medical billing claims. One important thing to learn is when you …
Make the Switch to Outsourcing for 2007
Outsourcing your medical billing claims to a third party partner may be one of the smartest business moves you make in 2007. You may have had every intention of doing your own medical billing for your practice from the day you opened until the day you retired, however with the never ending changes and nuances in medical billing claims varying from cancelled codes to nonpayment of certain procedures because they simply weren’t reported correctly – there comes a time when you need to look at your revenue flow from your reimbursements and decide it might be time to outsource your medical billing claims. Another reason to outsource is the small …
A Good Solution for Colonoscopy Confusion
There has been growing confusion over exactly how to report the growing number of colonoscopies that become “diagnostic”. This procedure has become more and more commonplace and the debate continues. Sometimes the best answer is the most obvious, contact the carrier and ask them how they want the procedure reported on your medical billing. Colonoscopies are part of a check up for most individuals over the age of 50, however when the colonscopy finds a polyp, you should normally use the polyp diagnosis in your medical billing claim and not the screening V code. The exception to this rule would be if the physician discovers a polyp during the screening, …
Medical Billing for Tissue Adhesives
One point that many medical billers find confusing is the correct procedure for coding the use of tissue adhesives when used for wound closures. The answer to this question will be different depending on which entity is paying the medical billing claim. When you code for the use of tissue adhesives, including Dermabond; Medicare has its own guidelines for reporting this procedure that you need to follow to be reimbursed. You should report G0168 for Medicare patients only. If you are reporting the procedure for a non-Medicare patient, you should use the CPT code that is the equivalent and that is 12001-12018 series (Simple repair of superficial wounds …). Another …
