Medical Billing Blog: Section - Medical Billing
Archive of all Articles in the Medical Billing Section
This is the archive containing links to all articles written in the Medical Billing 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.
Get Top Reimbursements for Skin Graft Procedures
In 2006 several changes were made to the CPT regarding skin graft procedures and this included the retiring of several codes and the addition of 37 new skin graft codes to make identifying the procedures more exact for medical billing claims. The skin graft section was also renamed to Skin Replacement Surgery and Skin Substitutes. There are new codes for autografts, sections 15100 through 15261, allografts, sections 15170 through 15176 and xenografts, sections 15400 through 15431. These codes seem to have been created in order to represent some new procedures and techniques. Many of these new codes are also specific to a particular technology or product make sure that your …
Get Better Reimbursements on Common ER Procedures
Knowing when to use code 90782 in emergency department procedures can help with your medical billing reimbursements. For example, if a doctor examines a patient in the ED for an injury, and injects a preventative tetanus toxoid, your first instinct might be to use 90782 as a modifier for this procedure. But you would not receive a medical billing reimbursement because the incident to provision does not apply in the emergency department so you would not be able to justify having the doctor administer this injection. There would be no way to justify the medical necessity of such a shot. However, when you are in an office setting the CPT …
ICD-9 Updates Coming October 1, 2007
Are you ready for the updates coming on October 1? There are a number of changes that will affect that way Medicare reimburses your practice for the services rendered as well as adding and retiring other codings. All of these changes will be effective for service dates after October 1. You can avoid a lot of paperwork hassles and denials by making the jump to outsourcing your medical billing. Your third party partner will keep up with the ICD-9 coding changes, rules and regulations and if you choose, can even do an audit of your current medical billing methods and show you how you can realize a better reimbursement rate …
When to Use 90782
Knowing when to use code 90782 in emergency department procedures can help with your medical billing reimbursements. For example, if a doctor examines a patient in the ED for an injury, and injects a preventative tetanus toxoid, your first instinct might be to use 90782 as a modifier for this procedure. But you would not receive a medical billing reimbursement because the incident to provision does not apply in the emergency department so you would not be able to justify having the doctor administer this injection. There would be no way to justify the medical necessity of such a shot. However, when you are in an office setting the CPT …
Make Sure You’re 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 …
Aural Rehab Not Reimbursed?
Medical billing changes occur throughout each and every year and keeping up with those changes can be confusing. Aural Rehabilitation has become one major area of confusion since the 2006 update. The medical billing changes to Aural Rehab CPT codes has wrongly caused many people to believe Aural Rehabilitation is no longer a reimbursable service. 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. …
Code Designations Determine When to Use Modifier 59
When do I use medical billing modifier 59? This is a great question. It is one that many don’t ask, but most don’t know the correct answer to. One of the most important things to know about the medical billing modifier 59 is which code on which to append it. There are some basic medical billing rules that can teach you which code to use with modifier 59. The general assumption about modifier 59 (Distinct procedural service) is that it should be linked to the lower-valued code of the pair. Although this may be true a lot of times, it is not always true. There is a much better rule …
The Inside Scoop on Medical Billing for Tissue Adhesives
Coding for tissue adhesives can be confusing because there isn’t one set procedure for this. The coding that is used is determined by the type of wound and the severity of the repair when tissue adhesives are used for wound closures. The answer to this question will be different depending on which entity is paying the medical billing claim. When you code for the use of tissue adhesives, including Dermabond; Medicare has its own guidelines for reporting this procedure that you need to follow to be reimbursed. You should report G0168 for Medicare patients only. If you are reporting the procedure for a non-Medicare patient, you should use the CPT …
Gastric Bypass Codings Becoming More Common
As a medical biller, you may be seeing an increase in the number of gastric bypass claims that you are handling as more and more insurances are covering this procedure as a measure to remove the patient from danger of developing more serious, chronic and costly illnesses that can stem from being grossly obese. After a patient has undergone gastric bypass surgery, eventually they will have the band removed. Many medical billing professionals are amiss at whether to include modifier 59 with their claim in order to obtain reimbursement for the procedure. Under The Correct Coding Initiative (CCI), normally the procedure of removing the band and port removal would be …
Can Your Practice Benefit From the Auditory Rehabilitation Boost?
The Centers for Medicare and Medicaid Services have recently made it known that the reimbursement for procedural code 92696 is going to be increases by a rather large amount. To clarify a little bit further, the reimbursement to providers for such a procedure will come in at approximately four times the amount being received currently. This should make any of the providers of language, speech and hearing much happier when it comes to medical billing. This entire thought of reimbursement may be a lot clearer if it is broken down a bit. For example, the code 92626 which is known for the description of Evaluation of Auditory Rehabilitation Status; first …
