Medical Billing Blog: Section - Medical Coding
Archive of all Articles in the Medical Coding Section
This is the archive containing links to all articles written in the Medical Coding 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.
Are You Getting Maximum Reimbursements for ER Dislocation Procedures?
A common occurrence in the emergency is the dislocation of various joints. They are sometimes incorrectly handled as breaks but shouldn’t be and you could be setting your practice up for a denial at best and audit at worst if you report these procedures incorrectly on your medical billing. Even if the reduction of the dislocation fails, the attempt should be reported on not only the medical billing as a procedure but also in the documentation as another procedure will have to be tried to relocate the elbow to its proper placement and you can show the timeline for the necessity of other and more involved treatments. On the claim …
Getting Place of Service (POS) Codes Right
For correct payment amount, accurate place of service codes are required. The failure to provide the correct place of service code with the correct current procedural terminology code for E/M services will cause your claim to get denied. One of the most important elements of medical billing is the place of service code. In medical billing, the place of service codes for an evaluation and management are commonly misused. 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 (which …
HIPAA Clarifications Coming for Mental Health Workers
If you work in the mental health area, you can expect there to be a coming clarification on how HIPAA and FERPA should be interpreted along with a other state and federal privacy laws dealing mostly with situations concerning mental health workers when dealing with patients in conjunction with educations and law enforcement. This change is largely in part to the misinterpretations of privacy laws that were contributed to the Virginia Tech shootings earlier this spring, however it was not attributed to the laws themselves, concluded federal officials in a report to the President. The report was a compilation of data that was put together by several different agencies including …
Medical Billing Dilemma: Adjustment of Gastric Band
Sometimes after a gastric band procedure, the band may slip during healing and need to be adjusted. The uncertain thing is how to bill the procedure since you have already billed the global. HCPCS temporary code S2083 (Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline) or CPT code 43771 but both of these require that the physician use a laparoscope during the procedure and usually moving the band is done through injecting saline or removing saline from the band to make it easier to adjust through a subQ port. For most instances you can use S2083, normally you will only use 43771 if patient …
Break Out Well-Woman-Care Visits For Better Reimbursements
A little known fact about well-woman care is that in many cases, you can break out the breast exam and pap smear and realize a reimbursement for both procedures if the patient is covered by Medicare. If the physician provides a complete well-woman exam for a Medicare patient, you should report G0101 (Cervical or vaginal cancer screening; pelvic and clinical breast examination) for the breast and pelvic exams. When the physician also obtains a Pap smear, use Q0091 (Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory)and this will enable your practice to realize a reimbursement for both services. Just make sure that you have …
Taking the Headache Out of Credentialing
Are you swamped? So overwhelmed with patients, billing, invoices, emergencies and other day to day practice worries that you don’t even have the time to get yourself credentialed with all the carriers possible. No one has to tell you that the more insurances you accept, the more patients you can see and the more revenue you can generate for your practice. Credentialing is the key. Did you know your medical billing partner can take some of the heat off you and not only compile and submit your medical billing, they can also get your practice credentialed with any carrier you choose. If you have a busy practice, you may be …
Servicing Hospitals? Know Your CCR
Your provider number has a strong impact on your medical billing cost to charge ratio (CCR). If your hospital is merging with another hospital, it is important to figure in the possibly new Cost to Charge Ratio medical billing payments you will receive. There are two avenues merging hospitals can take. The first method is when two hospitals merge together while one of the existing provider numbers is kept in tact. In this instance, one hospital keeps their medical billing number, while the other one drops theirs and joins the first. The hospital that drops their medical billing provider number will receive a new cost to charge ratio. The ratio …
Digit Removal Medical Billing Questions
Just when you got a handle of medical billing, another policy throws a curve ball at you. In some instances, the same CPT code is used for two different procedures. An example of this is when performing both and extra digit removal and a skin tag removal. The same medical billing CPT code, 11200, would be used in both of these instances. The medical billing code 11200 means, removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions. This means that if an individual needs an extra digit AND a skin tag removed, than you would use 11200 to report both. To let the payers …
Getting the Indirect Supervision Code Right in Three Steps
For help with performing the care plan oversight services if you are having a hard time with the 993xx series these steps should help to get you started. Step one is to count these care services as 99374-99380. The 993xx series codes allows pediatricians to bill for coordination of care of special needs children without face to face visits. You can report these care plan oversight CPO codes as 99374-99380 for Doctor supervision. This is only for when the patient is not present for the following doctors services, a) revision or development of care plans for multidisciplinary and complex modalities. b) related lab and other studes review c) patient status …
434.91 – Stroke – Hemorrhage or Both?
When using 434.91 make sure you take all of the specifics into account. When a doctor says that a patient has had a stroke make sure that you know all of the details of the situation or else some procedures can be hard to justify and therefore your medical billing reimbursement may be denied. In the past for diagnosis of a stroke the ICD-9 index listed 436, which is acute but ill defined cerebrovascular disease, as the code to use. Now the index has code 434.91 as the code to use. This is cerebral artery occlusion, unspecified with cerebral infarction. The new ICD-9 index automatically translates a doctors diagnosis of …
