Medical Billing Blog: Section - Claims
Archive of all Articles in the Claims Section
This is the archive containing links to all articles written in the Claims 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.
ICD-10 Preparation Steps and Tips for Medical Providers
As a Provider, ICD-10 preparation, and the subsequent upcoming transition can be a bit daunting. The first thing I recommend you do is to assign one individual to be the driving force behind the process and to oversee the details. This could be your coder, office manager, biller or anyone in your staff with the drive to make it as smooth as possible. Next, you should begin to develop your timeline. It’s important for you to have goals in place so that you can achieve your plan. One of the key elements you will need to do in your preparation is to identify the most common codes that your practice …
Pediatric Patient History – Who Can Take It?
Contrary to popular belief, it is safe practice to allow any office member to take the review of systems and the family social history. These two evaluation and management history elements can actually be taken by absolutely anyone. It is ok in medical billing for a parent or a secretary to take down this information as long as the information is reviewed and signed off on by the acting pediatrician. The only part of an evaluation and management visit that the physician or nurse practitioner must complete for medical billing purposes is the history of present illness or the reason for the visit. By allowing your administrative staff to complete …
Surefire Tips to Identify Wound Repair Level
Wound repair causes a lot of confusion among medical billers and medical coders. It’s not always easy to identify the level of wound repair involved when reading an operative report. If you cannot quickly ascertain the level of wound repair, then you need to check for a few things. In order to identify wound repair level, you should look to the operative report for these key words and clues: -If a surgeon mentions single layer closure in his or her operative report, it is a simple repair. Simple repairs involve superficial wounds that involve “primarily epidermis, or dermis or subcutaneous tissues without significant involvement of deeper structures” according to the …
New HCPCS Medical Billing Tool
Your practice should know where to look for medical billing changes each year. When dealing with HCPCS consolidated billing, many billers become confused about what codes are excluded from this type of billing. Before allowing your staff members to do medical billing, be sure they know where to look for answers to their coding questions. The source to find consolidated HCPCS medical billing codes is no longer in the Centers for Medicare & Medicaid Services’ Skilled Nursing Facility Help File. Since September 25, 2005, CMS has tried to steer medical billing staff members away from this file. Now, however, it is more important to do so. A new website has …
How Your ICD Medical Billing Reporting Will Change
How Your ICD Medical Billing Reporting Will Change Next Year Medical billing is improving in the world of Cardiology. Before January 1, 2006, you must contact the ACC (American College of Cardiology) in order to enroll in a new ICD (implant able cardioverter defibrillator) data registry. It is the hope that this new repository will improve cardiovascular care and medical billing. On Oct. 27, 2005, the Centers for Medicare & Medicaid Services announced that hospitals must begin using the new data registry before the beginning of the year. The current system is called the Quality Network Exchange ICD Abstract Tool (QNET) and the new system is simply called the ICD …
Medical Billing for 92552 And You
Medical Billing for 92552 And You Performing medical billing for current procedural terminology code 92552 can be difficult to distinguish from 92551. These hearing tests are similar, but there are slight differences. When billing for these medical hearing tests, it is important to match chart notes with CPT codes. The medical billing CPT code 92552 means pure tone audiometry; air only. This is a hearing test that a physician uses when testing the limits of intensity for each frequency heard. This means, for each pitch, high or low, the physician sees what the patient can hear at the lowest intensity possible. When doing medical billing for this procedure, one must …
Update Your Reporting Method To Medicare
Update Your Reporting Method To Medicare or Face Denials Times are changing when performing electronic medical billing to Medicare. Beginning on August 1, 2005, noncompliant electronic claims billed will be denied. These billed medical claims must be compliant with the Health Insurance Portability and Accountability Act (HIPAA). Currently there is a medical billing contingency plan in effect that does accept these noncompliant claims, but that will soon end. In order to ensure the most efficient payment possible, submitting compliant electronic claims is recommended. Otherwise, the Centers for Medicare & Medicaid Services will send the claim back to you unprocessed and with no payment. To get medically reimbursed for this billing, …
Ready for your Medicare Site Visit?
Securing a Medicare provider number is a priority for any new practice. Properly submitted electronic Medicare claims can turn to cash in 21 days and can help establish a predictable cash flow. Part of the approval process includes a site visit and presentation of “QID’s” such as #14120: DOCUMENTED BILLING PROCEDURES that states “Sound practice management provides for defined billing procedures and reference materials as a component of increased accuracy.” When you engage a billing and coding company make sure the support team you choose is familiar with all Medicare procedures including the all-important site visit and the information required and presented during the visit. A company that is familiar …
Doctor Disciplined – Told to Take Medical Billing Classes
In Texas, a Bastrop physician and an Austin doctor were among the over 60 physicians that were disciplined y the Texas Medical Board. are among the 64 doctors the Texas Medical Board recently disciplined. The Internalist that was disciplined, Dr. Rajeev Gupta, was disciplined because five patients were improperly billed and the radiology equipment was operated by a staff member that was unlicensed. Dr. Gupta was fined $1000 and required to take a course in medical billing. The attorney for Dr. Gupta stated, “We realize there were mistakes, and we’re taking steps to make sure there are no additional mistakes,” said Alex Fuller, an Austin lawyer representing Gupta. “It wasn’t …
October Updates Are In Effect!
If you haven’t already, make sure that your staff is using the updated CPT codes that were released in October 2008. Not doing so can lead to kick backs that will require more staff hours to research, redo and resubmit and if this happens on a number of claims it can seriously affect your reimbursements and in turn – slow your revenue flow to a mere trickle. One way to avoid this dilemma is to outsource your medical billing and yes, there are some horror stories out there about outsource companies that threw away patient billing, had lax attitudes towards billing submissions and wound up costing the physician a lot …
