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.
Separating Payments on Separate Tests Performed
Did you know that you can actually bill separate tests performed from your practice for separate payments? Certain practices have been taking advantage of larger reimbursements by doing just that. Say that you have a patient that is new to your practice and they are coming in for an exam. You can both bill for that exam and then bill separate for any other tests or screenings that they will be having performed. Although you may feel as though you are doing something wrong when it comes to medical billing practices such as these. However, the important Centers for Medicare and Medicaid services have been doing a good amount of …
Using Place of Service Codes Correctly
More and more carriers are cracking down on medical billing claims that have a lack of or incorrect place of service code. Even with the correct current procedural terminology code for E/M services, a medical billing claim that does not have a correct POS code will get your claim denied. It is a common occurrence in medical billing for the place of service codes to be misused or left out. There are several current procedural terminology codes for an evaluation and management session that correspond to different medical billing place of service codes. When using CPT 99341 (Home visit for the evaluation and management of a new patient) through 99350 …
The Sensitive Issue of Handling Hard Copies
A question that comes up often is exactly how should a medical practice dispose of the hard copies of files? The answer isn’t rocket science, shredding is the only good answer. When you are ready to dispose of hard copies medical files, anything with a patient’s name on it should be shredded. If you don’t have the staff available and you don’t want to invest in an industrial-sized shredder, a good alternative would be to hire an outside shredding service that will either come to your offices and shred on site; or pick up your files, lock and store them in sealed containers and put them on a closed end …
Coding Chronic Pain Syndrome
“Chronic pain syndrome” can be considered as a vague description of a vague diagnosis by your carrier and unless you back up your medical billing with the reasons for using this catchall term for several pain conditions, you may be seeing only partial reimbursements to denials for this condition. Traditionally, ICD-9 directs you to code 338.4 (Chronic pain syndrome) for the condition. However, you may need to couple this diagnosis with other probable causes backed up by symptoms and doctor’s notes. Other diagnosis possibilities for chronic pain syndrome include fibromyalgia/muscular pain (729.1, Myalgia and myositis, unspecified); reflex sympathetic dystrophy/regional pain syndrome (337.2x, Reflex sympathetic dystrophy) or peripheral neuropathy (337.0, Idiopathic …
Are Your E-Transmissions HIPAA Compliant?
If you haven’t taken the time to evaluate your data; both the data that you actively send as well as the data at rest. If you don’t you could be in violation of the new HIPAA violations. The last security rule made by HIPAA (and while the final ruling does not mandate that you encrypt all of your email transmission)it does require that you examine how all of your data is transferred on an overall scale. There are two key items that will help you evaluate how your data is transmitted. (1)integrity controls and (2)encryption. Integrity control sounds a little confusing, but it really just means proper access controls and …
Using Q Modifiers on Foot Care Claims
Make sure that you and your staff are up to date on using Q Modifiers as these were updated in 2007. Make sure you are getting the best reimbursements by using the currently preferred modifiers to be reported when the physician is performing foot care. Modifiers Q7 (One class A finding), Q8 (Two class B findings) or Q9 (One class B and two class C findings) tell insurers why your physician is performing foot care. To determine which modifier applies to your physician’s claim, check out the following list of what Medicare and other payers include in each description: Class A Finding:Nontraumatic amputation of foot or integral skeletal portion thereof …
Are You Reporting Circumcision With Nerve Blocks Correctly?
There are some new guidelines for reporting a nerve block with a circumcision. In the past you may have reported this as two separate procedures using 54150 to document the circumcision and 64450 for the accompanying nerve block. However the AMA has revised code 54150 (Circumcision, using clamp or other device with regional dorsal penile or ring block) in the new edition of CPT 2007 to include the accompanying nerve block in the description of the service. As such, it would now be unnecessary to report 64450 (Injection, anesthetic agent; other peripheral nerve or branch) with 54150 for this purpose, and the National Correct Coding Initiative (NCCI) bundles 64450 into …
Tips for Handling Critical Care Evaluation for Pediatric Medical Billing Claims
Pediatrics is one of the most complex areas of medical billing. It has many medical billing codes that were created just for the use of describing procedures. However, there are other areas of medical billing that do not have these specific codes for children. This can make coding hit or miss unless you know the nuances of what the carrier wants in order to get the maximum reimbursements for procedures performed. A common dilemma is with CPT code 99293 and its use for outpatient emergency room exams for an infant or if code 99291 should be used. The medical billing code 99291 means critical care, evaluation and management of the …
Been Hit With Medically Unlikely Edits Denials?
It can happen to any individual who is involved with coding, dealing with MUEs can end up being a nightmare if you do not know when and how to use them. MUEs, which is short for the term Medically Unlikely Edits, happen to be put in place to try and help limit the amount of billing errors. The more you understand them, the better off you will be when you find that you need to use them. If you are worried about dealing with MUEs, then you really should know that you are not alone. Luckily, there are a couple of things that you can look to and keep in …
Medical Coding for Multiple FB’s in the Same Site?
Foreign bodies as you are well aware present often as people get in all sorts of accidents at the home and on the job. From the splinter in the eye from the weekend warrior who decided he was too cool to wear safety glasses when he was building a table to the kid that came into the ER with multiple embeds under the skin; they are all reimbursable procedures and if you aren’t getting half or better reimbursements, then you need to brush up on your coding and make sure your medical billing claims are airtight. Generally, it is always best to use only one code for foreign body removal …
