Medical Billing Blog: Section - General Info
Archive of all Articles in the General Info Section
This is the archive containing links to all articles written in the General Info 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.
New to Medical Billing?
Understanding the basics of medical billing will make it easier to process claims and do your coding correctly, even if you don’t work in the industry full time or you are new to working in a practice. You will hear two terms over and over. ICD-9 and CPT. These are the two coding systems that are used to process medical billing forms. The first acronym is the one that identifies the type of disease or physical state of the patient being treated. Those are the ICD-9 codes which stands for International Classification of Diseases, 9th Revision, Clinical Modification, or shortened ICD-9-CM, codes) and another that describes the procedures, services or …
Eliminate Confusion Over 99053 and 99058 in Billing
There were two new codes issued in 2006 that continue to confuse many medical billers. These two codes were created to specifically address the after-hours and red-eye services for procedures done by physicians outside the normal hours. Previously when compiling the medical coding for medical billing, a coder would have used 99050 as a “catch-all” coding. Now CPT has revised the original code and added new codes. 99053 is “for services between 10 p.m. and 8 a.m. in 24-hour facilities,” and will be used by both physicians on call and hospitals. Please note that code 99053’s wording to include “24-hour facility” will put a new limitation on using late night …
When to Provide Family and PH V Codes
With all of the various codes in relation to the medical field, some may tend to become a bit confused when it comes to figuring out the difference between both personal and family history V codes. Basically, what you need to remember is that the V codes are there to help give a window into past patient history. If there is an ongoing medical condition, the V codes can be used to tell the tale. When looking into personal history, you can find out more about any prior procedures, hospitalizations and operations, as well as any previous illnesses and injuries that the patient has endured. This can help to show …
Easy Tips for Dealing With Pesky Pessary Coding
Have you ever struggled while dealing with pesky pessary coding issues? If so, then it is a great idea to come up with some sort of strategy that will help you to better understand these codes as well as the different reasons for them. When you are dealing with the pessary codes, you should take several things into consideration including the information provided in manuals, the procedures at hand, what the policies are for the particular practice and all of the supplies that are involved. Basically, the definition of a pessary is a specific support device to aid in weaknesses of the pelvic floor. Such weaknesses or problems will include …
Hold Ups On Medical Billing Claims Due to Zip Codes
Effective January 1, 2007; if you do not include your zip code on your medical billing claims that are submitted to Medicare for reimbursement, you can count on a delay. A National Provider Identifier requirement to include your zip code on all billing transactions took effect Jan. 1. This included all bills including RAPs, and providers must report a five or nine-digit zip code for their primary facility and its subparts. Claims without the zip codes will be returned to provider (RTP’d) with reason code 32114. This will affect any facility that does medical billing claims for Medicare reimbursement. Many providers were unaware of the new requirement and a large …
6 Tips for OB-Gyn Medical Billing
For maternity, a global medical billing is the most common form of claim submission. This can get very tricky for the personnel in your office. Be sure to train your medical billing staff the correct way to bill global maternity claims. There are 6 medical billing tips for global Obstetrical care. First, be sure that your diagnosis code (ICD-9) range in the 640-678 numbers. These are the only acceptable ICD-9 codes for global maternity care. Diagnosis codes are the first step to a correct claim. The second tip also deals with the diagnosis code. Be sure you use the correct fifth digit when you decide to use this many numbers. …
What are NCCI Edits?
If you’re still uncertain what a mutually exclusive edit is and whether you’re using the latest NCCI version in your ob-gyn practice, you could be setting yourself up for future reimbursement hassles. The National Correct Coding Initiative edits are pairs of CPT or HCPCS Level II codes that Medicare (and many private payers) will not reimburse on an individual basis except under exceptional circumstances. Medicare applies the edits to services billed by the same provider for the same beneficiary on the same date of service. Example: The most recent edition of NCCI (version 12.2), effective July 1, includes an edit bundling therapeutic injection code 90772 (Therapeutic, prophylactic or diagnostic injection …
Get Your Inpatient Medical Billing Reimbursed Better
Ob-gyn patients present a lot of unique problems for medical billing. In the case of a pregnancy, the condition usually won’t have a long historical documentation. There isn’t a certain number of inpatient admission days for delivery patients that can be billing globally as each delivery is unique. You did to ascertain if the patient developed complications and also if the ob-gyn is also the treating physician or only making rounds with the patient. You will need to separate out the claim for some carriers accordingly. That will narrow down if you need to bill this claim globally or not. In the case that the patient is not admitted for …
4 Points For Easy Inpatient Billing
One of the most difficult medical billing feats is inpatient consultation coding. There are many instances when a follow-up inpatient consult should be replaced by a subsequent hospital care visit. To eliminate these medical billing errors, there are four facts to consider when coding for inpatient consults. Number one is very obvious. If your report an inpatient consultation exam, the patient must be inpatient, not outpatient. Very often physicians see patients on a consultation basis when they are outpatient. Medical billing mistakes can be made easily. Double check your work. Number two, it is important in medical billing to always report one initial consultation. This code will correspond with the …
The Basics of Outsourcing Your Medical Billing?
If you’re wondering how your medical billing gets to the outsourcing company, the answer is carefully and securely. The patients are seen as usual in your office, your staff creates the records for billing just as they always did. If you are still using paper files your claims will need to be scanned and hand entered into the medical billing system, if you transmit electronically your staff will need to only access the program and transmit the chosen claims to be processed by the medical billing company. The data will be transmitted to the medical billing company who will code and double check your medical billing claims to insure they …
