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.
How Private Is Outsourcing Your Medical Billing?
Confidentiality is a big concern in every corner of the medical community. Now that you’ve done your homework, you know outsourcing your medical billing is good for your practice and good for your staff. You know Electronic Claims Filing is the best way to file your medical billing claims, but you have concerns about exactly how private sending your medical billing out of your office to a third party might be. Privacy and security have become major issues for those in the medical profession and for the companies that handle your medical billing and coding. Rest assured, your claims are handled in complete confidence and your patient’s privacy is secured …
Can DME/HME Be a Profitable Venture For Your Practice?
Even two years ago the answer to that question might have been “no”. However, in 2007 it might well worth looking into for your practice. Previously, the cost of the products versus having to track claims, find reimbursements, and keep up with claims status; made DME a very labor intensive venture. With the advent of specialized DME/HME software, secure internet connections, and standardized billing procedures; DME can now be a very profitable venture. In your practice, you will want to be sure that the product(s) you are dispensing are profitable. You need to watch the pricing of the product costs, in some instances, your product costs may be more than …
Avoid Under-Billing Neonatal Services
Under-reporting medical billing claims is unfortunately common and it costs revenue as you’re not being fully reimbursed for services rendered. Learning the exceptions to the bundles will allow you to break out services that can be billed alone – once you start investigating neonatal services you’ll realize quickly that you may have very been missing legitimate reimbursements. A scenario that isn’t uncommon is when a doctor attends a delivery of a 28-week gestation baby. The infant received positive pressure ventilation (PPV) in the delivery room (DR) with mask and bag for absent respiratory effort at birth. The baby was then intubated in the delivery room and received PPV on transfer …
Critical Care NCCI Edits For 2007
NCCI has some important updates for 2007, If you need to report an emergency department (ED) visit as well as a critical care code (99291), you should keep in mind that a bundle, care of the National Correct Coding Initiative (NCCI), version 12.3, prevents you from reporting both. The code range that you should be aware of is 99281-99285 alongside critical care code 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes). The ED visit is now a component to the comprehensive critical care service with the new NCCI edit, you can’t separate this with a modifier. There are currently no known …
Medical Billing For Mastectomy and Lymph Excision
When the surgeon removes lymph nodes during a partial mastectomy, it may be confusing as to how to the mastectomy and the lymph excision. A common point of confusion is whether they should be bundled or reported separately. The answer is pretty cut and dried. In most cases, with partial mastectomy, the surgeon will perform an axillary lymphadenectomy to remove the lymph nodes between the pectoralis major and the pectoralis minor muscles. The surgeon may also remove the nodes in the axilla through a separate incision at the same time. When this occurs, you should not report the mastectomy and lymphadenectomy (38745, Axillary lymphadenectomy; complete) separately. Instead, you should use …
Reporting Your Ulcer Treatment Claims Correctly
Often, patients who are confined to beds for long periods of time develop pressure ulcers. They are painful and need to be treated as quickly as possible as infections can set up within them that can be life threatening when the patient is already in a weakened condition. When a service is performed for a patient such as treatment of a pressure ulcer on an area of the body such as the lower back, the usual manner of treatment is to remove any devitalized tissue from the ulcer using a water jet and forceps. The area is then covered to allow it to not be rubbed on so the skin …
Sure Fire Reimbursement Techniques On Your FBR Medical Billing Claims
When you’re reporting a medical billing claim for foreign body removal (FBR) from the eye on many occasions you may not be getting the full reimbursement that is due because you might be missing something extra. A good example is if a patient presents to the ED with a foreign body in her left eye. The ED physician performs a removal of the foreign body and uses a slit lamp in the procedure. A level three evaluation was also performed to check for additional injury caused by the presence of the foreign body. In most cases, you’ll be able to report a pair of CPT codes. One for the ED …
Interesting Study About Doctor’s Charges
A recent study came up with a staggering conclusion, nearly three-fourths of U.S. consumers said they know little to nothing about how the fees of their doctors compared to other physicians in a similar practice. Furthermore the study concluded the most Americans actually underestimate what their providers charge. For example, most adults (65 percent) think that, in general, a high-priced doctor in the U.S. charges two or three times as much for the same procedure as a low-priced doctor. In fact, a review of HealthMarkets data for several selected procedures shows that some doctors charge nearly 10 times what others charge for the same procedure. Additional information gained in the …
Noting When Radiation Therapy Is Twice Daily?
The opinion released by The Centers for Medicare & Medicaid Services (CMS) has said you can bill for twice-daily radiation therapy as long as the treatments happened in “different sessions.” But you have to be careful to follow the rules and avoid getting into trouble by billing for “different sessions” that were really just parts of the same session. A procedure called “hyperfractionation” is defined as any technique of radiation treatment that delivers more than one treatment session per day. If you’re stumped how to make sure that a session is separate from another session, just know this: to be considered separate, two sessions should be at least six hours …
Medical Billing Claims for Tests That Are Normal
If you have a medical billing claim to file and the test that was performed on the patient comes back without any definite diagnosis, don’t discount the fact that you won’t be reimbursed for the medical billing, instead you need to determine whether the test result is normal, negative, or inconclusive and that final reading will determine how your medical billing claim should be handled. If your test comes back inconclusive, you shouldn’t report a diagnosis that the laboratory gives you after a pathology test. Many practices mistakenly report the lab’s diagnosis because they feel that claim will legitimately get paid. A good rule of thumb is to code the …
