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.
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Eliminating SSNs in Medical Billing
Eliminating SSNs in Medical Billing The Durbin amendment will make medical billing safer for senior citizens in the United States. The Durbin amendment makes it mandatory for the federal government to remove social security numbers from all Medicare documents and replace them with a different patient identifier. Since senior citizens are a large target of identity theft, this medical billing change is definitely one for the better. Beginning in 2006, the federal government has gotten on the same page as many states of the nation. Identity theft is so prevalent in the United States and social security numbers make identity theft easy. This means that all senior citizens with Medicare …
Overstated Payment Amounts In Medical Billing
Watch Overstated Payment Amounts In Your Medical Billing The state of Indiana is raising some eyes in the medical billing world. The Centers for Medicare & Medicaid Services have strict regulations for payments and upper payment limits (UPLs). Apparently Indiana significantly overstated these amounts, which led to large over payments. Now, the Indiana medical billing overstatements may affect their bottom line. The Office of Inspector General announced that for the Indiana state fiscal years 2001 and 2002, they overstated upper payment limits by about $6.5 million. The medical billing in 2001 was overstated by $2.2 million, and 2002 medical billing was overstated by $4.3 million. The reason these medical billing …
Four Coding Myths That Will Cost You
Four Coding Myths That Will Cost You Ob-Gyn coding is a serious medical billing issue. There are many assumptions and myths that billers make when filing claims. Assumptions can cost your practice a lot of money. There are four myths in Ob-Gyn medical billing you should forget. 1st MythIt is incorrect to bill separately for the initial blood work with a nurse and also the initial ob-gyn visit. If blood work is being done, that should be included in the initial visit code, or the global package in medical billing. If your practice has been billing separately for these services, you may eventually need to repay overpayments. 2nd MythAnother myth …
Proper use of 90782 billing code
Proper use of 90782 billing code Like any other medical billing code, there is an appropriate time to use the current procedural terminology code 90782. Some people wonder if this code is appropriate when doing medical billing for a tetanus toxoid injection in the emergency room. In medical billing, the best CPT code is the code that most accurately describes the service. In the emergency room scenario, it would not be appropriate to do medical billing for a 90782 (Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscularly) for a tetanus shot. In the emergency room, it would be very difficult to prove it medically necessary for a physician to administer …
Do You Know Your Medical Billing RUG’s?
Do You Know Your Medical Billing RUG’s? The New RUG III should bring added reimbursement to freestanding facility medical billing across the country. These new changes will boost payment between 2.4% and 2.9% if the facility handles medical billing correctly. If medical billing is handled incorrectly, a drop in payments could be seen for skilled nursing. Training is of the utmost importance coming up on the new year. If a facility has rehab residents with cushioned care with add-on payments, the RUGs will throw them into a lower paying bracket. Understanding the Medicare per diem levels will be very important when it comes to reimbursement for services. There are several …
Medical Billing For Lower Extremity MRIs
Medical Billing Reimbursements For Lower Extremity MRIs Medical billing hip MRI rules are not as straightforward as you might assume. There are many variations on how to correcting bill for this service. There are some facts you should keep in mind when doing medical billing for lower extremity MRIs. Unfortunately, there is no specific medical billing CPT code for an MRI of the hip. You need to use the codes 73721-73723 (Magnetic resonance imaging, any joint of lower extremity). The hip joint falls into this medical billing category because it is a lower extremity joint. Doing medical billing for bilateral hip MRIs is also a bit more complicated. Different payers …
Correct Coding For ADD Follow-up Visits
Correct Coding For ADD Follow-up Visits Since attention deficit disorder is so prevalent, medical billing knowledge must also be. ADD walks a thin line between mental health coverage and medical coverage to many payers. To get reimbursed correctly for ADD follow-up visits, correct medical billing is necessary. There are two types of medical billing codes to use for ADD follow-up visits: mental health codes, and evaluation/management codes. 90862 (Pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy) is the mental health code. Many insurance companies will deny this medical billing if your physician is not a mental health provider. The evaluation and management …
Medical Billing Reporting For Inpatients Made Easy
Medical Billing Reporting For Inpatients Made Easy 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. The first fact 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. It is important in medical billing to always report one initial consultation. …
Separate Medical Billing For Separate Tests
Separate Medical Billing For Separate Tests 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 …
Appeal When A New Code Claim Isn’t Paid?
Should You Appeal When A New Code Claim Isn’t Paid? HIPAA regulations are in place to prevent medical billing games. When current procedural terminology codes and ICD-9 codes are introduced, they have a certain effective date attached to them. This effective date states the very last day in which payers and providers must recognize the new code. It is illegal to deny claims for medical billing non-recognition. Providers deny claims all the time. There are various reasons for claim denials. These can range from a non covered service, to not substantiating medical necessity for a service. However, it is against the rules to deny medical billing because their system doesn’t …