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.

Using 92630

Aural Rehabilitation has caused a lot of confusion regarding how to do the medical billing correctly for the best reimbursements. Additionally, medical billing changes to Aural Rehab CPT codes have incorrectly caused many people to believe Aural Rehabilitation is not covered. Medicare actually assigned status code “I” to all new medical billing codes for auditory rehabilitation. These codes are 92630 and 92633. This means that the Centers for Medicare and Medicaid Services will not pay for auditory rehabilitation, only diagnostic audiology. However, this is only true if an audiologist performs the service and the medical billing. There are several other medical professionals that could possibly perform medical billing for aural

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Bigger Reimbursements for 92626

Medical billing in the speech, language, and hearing community is looking a little more lucrative. A transmittal released by the Centers for Medicare and Medicaid Services announced a dramatic increase for reimbursement for the Current procedural terminology code 92626. Medical billing reimbursement will be nearly four times the old amount for this code. The current procedural terminology code 92626 (Evaluation of auditory rehabilitation status; first hour) was reimbursable at $22.07. This has changed. Medical billing now allows this code to be valued at $81.76. The relative value unit (RVU) used to calculate this medical billing reimbursement was 2.20. Originally the RVU was 0.55. The American Speech Language Hearing Association (ASHA)

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Get Better Reimbursements with 77470

There are some cases when certain medical billing practices can get your office more financial reimbursement. The use of the current procedural terminology code 77470 is one of those instances. This code, however, cannot be used all of the time. There are certain things you must keep in mind before using the medical billing code 77470 for your claims. Sometimes the physicians in your clinic can see patients with special needs. For instance, an oncologist may see a patient that has a pacemaker. The pacemaker can make visits and treatment plans more time consuming for the physician. In this instance, the medical billing code 77470 may be used. 77470 in

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Split Out Your Coding for Chronic Kidney Disease

There have been some ICD-9 coding changes for chronic kidney disease (CKD) medical billing. In mid-2006, CMS revamped the CKD diagnosis coding section and now, if your practice treats a patient that suffers from CKD, you will need to use one of the stage specific codings the 585.1-585.5 series. Here are the CKD diagnosis codes that CMS wants you to use in 2006: * 585.1–Chronic kidney disease, stage I. Use this code for patients who have kidney damage with normal or increased glomerular filtration rate (GFR), greater than or equal to 90 ml/min/1.73m. * 585.2–… stage II (mild). This code represents kidney damage with mild decrease in GFR, 60-89 ml/min/1.73m.

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Getting Your Medical Billing Claims Paid

If your medical billing forms don’t have the proper diagnosis codes listed on your billings that are submitted to Medicare & Medicaid Services, the claim can be rejected. Any claim without a valid diagnosis code will not be processed. In previous years, when claims came in from service providers with incorrect diagnosis codings, the Medicare carriers would make the proper corrections and then reimburse the medical billing claim. Medicare personnel will no longer perform that function. Absolute correct coding is now required in order to reimburse for Medicare Part B services. A lot of service providers used to rely on this correction by the personnel at Medicare. As this is

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Are You Using Modifier 22?

In the world of medical billing, modifiers can be just as important as the CPT codes they append. A simple mistake such as miss sequencing these codes could lead to incorrect reimbursements. There is one modifier that is known as being the most incorrectly used modifier: 22. Knowing how to correctly use the medical billing modifier 22 is an important skill to learn. Modifier 22 (Unusual procedural services) is used to indicate a substantial amount of extra work a physician needs to do for a specific procedure. As a matter of fact, there are some procedures that never get separately reimbursed unless modifier 22 is used in medical billing. The

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The Importance of Accurate E/M Claims

Medical billing largely depends on the accuracy of the physician’s records. Many times physicians have nothing to do with the medical billing aspect of their practice or facility. This can cause them to be haphazard with their documentation for their patients. It is important to educate physicians about the importance of accurate records to the medical billing department. With rising healthcare costs, carriers are becoming much less lenient on treatments and procedures being covered. They also have become sticklers for accurate medical billing documentation submissions. If there is anything incorrect on a claim, it gets sent back to the provider without payment. There are many evaluation and management claims that

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Separate Billing Equals Better Reimbursements

The Centers for Medicare & Medicaid Services has improved medical billing reimbursement for Medicare patients. Currently, if your practice does medical billing for a Medicare exam on a newly 65 patient, you can also bill for cardiovascular screening tests and diabetes screening tests. The Centers for Medicare & Medicaid Services realizes that separately billing for these screening services may seem incorrect. For this reason they are sending out plenty of medical billing information to explain how to bill for preventative care in the future. For instance, one of the things physicians can bill for separately is diabetes screening tests. As long as one risk factor is established and two of

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Are Your Using the Common Working Files With CMS?

The biggest medical billing problem is getting denied payment for a claim. A service for which many patients are denied is smoking or tobacco-use cessation counseling. Payers have a hard time paying for this service. The patient either has no coverage, or is only allowed a certain amount of counseling sessions for the smoking cessation purpose. What happens if another physician has already done medical billing for these counseling sessions? Chances are, you would not get paid. The centers for Medicare & Medicaid Services have come up with a medical billing solution to let you know how many sessions a patient has already used. Let’s say you know your patient

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Medical Billing for Type A Claims

Many times, one medical billing mistake with a Part A claim can cost thousands of dollars. Proper training can eliminate most of these errors. Consolidated medical billing should be engrained into the heads of your personnel. There are some basic tips you should follow when doing consolidated medical billing. There are several medical billing charges that should be excluded when it is a hospital providing the service to the patient. The Centers for Medicare & Medicaid Services gives this list to exclude: computerized axial tomography scans, ambulatory surgery in the operating room, MRI, cardiac catheterizations, radiation therapy, angiography, emergency room services, venous and lymphatic procedures, and ambulance services related to

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