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.
Documenting for Chiropractors and Podiatrists
In 2007, Medicare is going to continue their close scrutiny of chiropractors and podiatrists. The claims submitted by these fields will continue to get looked over due to the extreme amount of fraud that has occurred in these two branches of medicine. Additionally, the stringent guidelines that are currently in place for chiropractors and podiatrists in order to meet payment requirements for certain procedures and debridement services will be getting looked at very closely and continue to be required in order to get their medical billing claims paid. If you perform these services or you are a medical billing company that does claims for these types of practices, check and …
A Common Reason for Rejection
One way that many medical billing claims get rejected for the smallest of errors. In many cases it can be something as simple as an incorrectly used modifier causing your claim to be rejected by the carrier. There are two modifiers that get a lot of people in to trouble in the form of rejected claims as they can be confusing and those are modifier 25 and 57. Modifier 25 which reads , “Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service” is kind of a catch all modifier for procedures that may not have an exact coding …
Confused About Flu Shots?
During flu season, flu shots are common in the medical billing world. Like everything else, there are many different flu current procedural terminology codes from which to choose. There are three steps to follow to ensure your flu shot medical billing is completely accurate. The first step is to figure in the age of the patient. Any patient who is age three and above should be given one of two medical billing codes: 90656 or 90658. The medical billing code 90656 stands for: influenza virus vaccine, split, virus, preservative-free, for use in individuals 3 years of age and above, for intramuscularly use. The code 90658 in medical billing means: Influenza …
Caution When Using Modifier 59 in 2007
Modifiers can be a helpful addition to medical billing. However, there are certain modifiers that are constantly used incorrectly. The contractors for the Centers for Medicare and Medicaid Services are now keeping an eye out for suspicious modifiers. The medical billing modifier 59 is on the list of modifiers to flag for review. Recently, the U.S. Office of Inspector General released a report that showed some daunting medical billing news. Modifier 59 has been the cause of over $59 million in overpayments to nursing homes and providers. Due this large number of overpayments, Medicare contractors will be closely scrutinizing each medical billing submission that contains the modifier 59. Another medical …
Medical Billing Tips for Cardiac Rehab in 2007
Cardiac rehabilitation staff members have great medical billing news coming their way. The Centers for Medicare and Medicaid Services expanded coverage for cardiac rehab. The medical billing element for cardiac rehabilitation will be much less strict when it comes to requirements. In the past year, the requirements in order to get medical billing reimbursement for cardiac rehab were strict. You had to have a heart attack, angina, or coronary artery bypass surgery. The Centers for Medicare and Medicaid Services now realizes that this type of care does not prevent any problem from occurring. It was merely reactive treatment. In December of 2005, the Centers for Medicare and Medicaid Services announced …
Medical Billing for Auditory Rehabilitation
Medical billing in the speech, language, and hearing community is looking a little brighter, medical billing reimbursement will be nearly four times the old amount for this code.There was a dramatic increase in the amount in 2006, however many practices are not taking advantage of this increase. 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) was the reason the RVU was …
How Can An Outside Audit Help Your Practice?
No one likes the word “audit” but sometimes it can help your practice. When it’s coming from the IRS or other authority office, an audit can be a major stressor; when you enlist the services of a third party partner to do an audit on the way your medical billing is filed – there are no penalties – only pluses! An internal audit of the way your medical coding and billing is handled can alert you to problems you may not have even been aware existed. Staff members can be adverse to change and continue using coding combinations that do not result in the maximum reimbursement for your services. When …
Office Visits And Well Checks
Any time you are coding for problem visits that a patient has, it is important that you take into consideration any other office visits that they may have recently had. Basically, you are going to want to look to see if there is a connection between visits for preventative medicine as well as current health issues that may be in place, which also needs some attention. Many times, a physician will end up seeing a patient that shows up in search of a visit to fall into the category of preventative medicine. Then, upon further evaluation, the doctor will then need to look at the patient further for some sort …
Avoiding Costly “Medically Unlikely Edit” 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 …
The Scoop On Foreign Body Removal
Foreign body removal is a common procedure for most practices and as such it would seem very simple and forthright to code for this service; however that’s not always the case. It is very important that you take care when processing all of your cases involving foreign body removal. Many times, if you end up mixing up a code with the wrong place, your practice could find that there will be problems down the road when trying to receive the proper amount of reimbursement. Pay close attention to the exact part of the anatomy where the service was performed as the codes for reporting FBR have become much more detailed. …
