Medical Billing Blog: Section - Medical Data

Archive of all Articles in the Medical Data Section

This is the archive containing links to all articles written in the Medical Data 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.

Windows XP Will Not Be HIPAA Compliant in April 2014

If you are still using Windows XP machines, you need to be getting rid of them soon. As Mike points out over at Hitech Answers, April 8th is when Microsoft ends all security updates, which puts you in direct violation with HIPAA. “Time’s up. On April 8, 2014, Microsoft is ending security updates and patches for Windows XP and Office 2003. Just having a Windows XP computer on your network will be an automatic HIPAA violation, which makes you non-compliant with Meaningful Use and will be a time bomb that could easily cause a reportable and expensive breach of protected patient information. HIPAA fines and loss of Meaningful Use money

Published By: OMG, LLC. - Corporate Entries | No Comments

Pediatric Patient History – Who Can Take It?

Contrary to popular belief, it is safe practice to allow any office member to take the review of systems and the family social history. These two evaluation and management history elements can actually be taken by absolutely anyone. It is ok in medical billing for a parent or a secretary to take down this information as long as the information is reviewed and signed off on by the acting pediatrician. The only part of an evaluation and management visit that the physician or nurse practitioner must complete for medical billing purposes is the history of present illness or the reason for the visit. By allowing your administrative staff to complete

Published By: Kathryn E, CCS-P - Retired | No Comments

Doctor Disciplined – Told to Take Medical Billing Classes

In Texas, a Bastrop physician and an Austin doctor were among the over 60 physicians that were disciplined y the Texas Medical Board. are among the 64 doctors the Texas Medical Board recently disciplined. The Internalist that was disciplined, Dr. Rajeev Gupta, was disciplined because five patients were improperly billed and the radiology equipment was operated by a staff member that was unlicensed. Dr. Gupta was fined $1000 and required to take a course in medical billing. The attorney for Dr. Gupta stated, “We realize there were mistakes, and we’re taking steps to make sure there are no additional mistakes,” said Alex Fuller, an Austin lawyer representing Gupta. “It wasn’t

Published By: Melissa C. - OMG, LLC. CEO | No Comments

Outsourcing a Dirty Word toYou?

The word “outsourcing” has become a dirty word for many physicians that have been burned by medical billing companies that either outsourced their claims to medical billing companies that use neither secure networks nor adhere to HIPAA regulation in order to maximize their profits; or the outsourcing company just turned out to not be reliable and it wound up costing the practice money to utilize their services. Don’t let a bad experience keep you from partnering with a legitimate medical billing company that can not only help you get your reimbursements faster but also realize great profits by maximizing every single medical billing claim that is filed to make sure

Published By: Melissa C. - OMG, LLC. CEO | No Comments

Correctly Reporting Wound Length

When a patient reports to the ED and requires laceration repair, the medical billing claim needs to address the length of the wound in order to be a properly filed claim. If the wound length is either not addressed or addressed incorrectly, the claim may be either denied, rejected or only partially paid. Additional factors can include whether or not there was a separate evaluation and how the service was managed during the encounter. Make sure all of these factors are documented in your medical billing claim. Laceration repairs are very common in the ED, in fact a nationwide survey showed that every one in fifteen patients presenting in the

Published By: Melissa C. - OMG, LLC. CEO | No Comments

Home Care Payments Will Be Getting Close Scrutiny in 2008

On October 17, 2007 – the Senate Finance Committee met to discuss ways to pay for a fix to physician payment rates in 2008 and 2009, according to press reports. The heart of the meeting was to talk about the $30 billion in cuts needed to avert the doc pay cut and make other Medicare changes, and home care once again landed on the chopping block to have many home services radically reduced or have their funding cut all together.Some of the specifics of the home care that were discussed to be directly affected were wheelchair suppliers and oxygen providers are under discussion for reimbursement reductions to pay for the

Published By: Melissa C. - OMG, LLC. CEO | No Comments

Emphysema Diagnosis Coding Tips

Want to know why your emphysema claims aren’t being fully reimbursed? Often, the reason is that you’re lacking two things when you submit your claim. You aren’t being detailed enough with your coding and your don’t have enough detailed medical documenation to back up your full diagnostic testing that is required to accurately diagnose emphysema and narrow the degree and type. When you’re compiling the medical billing for an established patient with active emphysema (492.8, Other emphysema) and they present and are complaining of shortness of breath (786.05); the physician provides inhalation treatment, trains the patient on using the nebulizer at home, and provides an expanded problem-focused examination and medical

Published By: Melissa C. - OMG, LLC. CEO | No Comments

Common Varicose Vein Treatments

As more research is done regarding the relationship between varicose veins, blood clots and other complications; more and more patients are having the simple surgery and as a result there has been confusion about exactly how to code this procedure to get the fairest reimbursement for this service. Once you know the basics for setting it up – it’s easy! A good example would be if a patient with varicose veins in her left lower leg presents to the ED and is stating she has severe pain in her leg. One of the veins is clearly bleeding so the doctor will use a standard suture ligation to stem the bleeding

Published By: Melissa C. - OMG, LLC. CEO | No Comments

Do You Know the Three "R’s" of Consulting Reimbursements?

Since consultation requirements have increased in the last year as far as criteria for getting them reimbursed in your medical billing claims, there are some criteria you must be certain that your claims meet in order to justify using codes 99241-99255. It used to be simple and medical billing consultant merely had to meet the three “R’s” in order to justify medical billing claims for consultations. However the criteria for what does and does not constitute a consultation has changed and in order to make sure that your medical billing claims are paid, you need to reacquaint yourself with the three R’s of medical billing for consultations. The three R’s

Published By: Melissa C. - OMG, LLC. CEO | No Comments

Definity Still Definitely a Problem in 2007

The injectable contract agent named Perflutren better known as Definity has caused a lot of confusion as many providers are billing the incorrect code and Medicare and most other large payors switched the code for this service in late 2005 and 2 years later it’s still showing up on medical billing and causing numerous delays and rejections on medical billing reimbursements. If you’re a service provider that is still billing A9700, you could face delays in getting paid–or even denials on your medical billing claims. If the carrier approves the main echocardiography procedure, then it will usually approve the use of Definity as contrast. If you are not sure of

Published By: Melissa C. - OMG, LLC. CEO | No Comments