Medical Billing Blog with Medical Billing & Coding Info & Articles
Our blog contains news and articles relating to numerous healthcare sectors including revenue cycle management, medical billing, medical coding, ICD, HIPAA, practice management functions and more.
Taking the Pain Out of Handling Pregnant Patient Transfers
Medical billing for pregnant patients is a fairly cut and dried process. It’s easy to create medical necessity for the visits and it’s easy to show the reasons for the continued visits. That is, unless the patient transfers practices in the middle of her prenatal care. Pregnancy transfers scare many medical billing personnel, however you can use three easy tips and make your maternity patient transfers a breeze. How you do medical billing for a maternity transfer all depends on how many times she was seen in the clinic. If she was seen 1-3 times you always want to code those visits as evaluation and management visits. One thing to …
Multi-Day Observation Claims Don’t Have to Mean Rejections
Confused about multi-day observations? Well, you’re not along. Multi-day observation medical billing claims can cause a lot of confusion. In order to get the correct reimbursements on your medical billing claims, you need to be sure that your multi-day observation billings are reported correctly – otherwise you’re practice isn’t receiving the maximum reimbursements for the services rendered and you’re in effect – losing money. A main rule of thumb when doing medical billing for multi-day observation is to report per day of service. This means that if a patient is admitted late at night and isn’t discharged until the next morning, you report both service dates. The two current procedural …
Coding Follow Up Office Visits
Patient history is valuable any time you’re building up your documentation to show medical necessity for reimbursement of any procedure. 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 …
Ending Confusion Over 99000 Series Codes in Your Medical Billing
There were two new codes issued in 2006 that continue to confuse many medical billers still over halfway into 2007. These two codes were created to specifically address the after-hours and red-eye services for procedures done by physicians outside the normal hours. Previously when compiling the medical coding for medical billing, a coder would have used 99050 as a “catch-all” coding. Now CPT has revised the original code and added new codes. 99053 is ” “for services between 10 p.m. and 8 a.m. in 24-hour facilities,” and will be used by both physicians on call and hospitals. Please note that code 99053’s wording to include “24-hour facility” will put a …
Compiling Your Medical Billing for Specific Injections
B-12 injections are a very common procedure. If you’re only receiving partial payments or experiencing rejections of your claims, you may need to tighten up your handling of these claims as the codes and procedures for filing criteria have undergone changes in the past year. To eliminate potential medical billing problems, there are five steps to follow to ensure smooth B-12 reimbursement for your claim. The first medical billing step is to replace the injection administration codes for the B-12. These codes include the current procedural terminology codes 90782, 90788, and G0351. These medical billing codes were deleted from the 2006 CPT list and should no longer be used. The …
Global Billing for Ob-Gyn Services
One of the common dilemmas in medical billing for Ob-Gyn services is how to report the birth of a baby when there was no doctor on hand to deliver the newborn. When the delivery is progressing trouble-free, it isn’t uncommon is for a nurse to deliver a baby when the ob-gyn is in the next room doing a procedure on another patient such as an episiotomy; then the question arises, can the service still be billed globally? Fortunately in many cases you can. It is up to the individual payer and you can find out quickly by either checking their guidelines or website to see if the service will be …
CCI Updates You Need to Know
In the most recent updated of the Correct Coding Initiative (CCI) there are a number of edits you won’t want to miss if the services to the patient include debridement and treatment on the same burn site. CCI version 13.1 outlaws reporting a pair of debridement codes with certain burn treatment codes in most situations. However, CCI now bundles 11000 (Debridement of extensive eczematous or infected skin; up to 10 percent of body surface) and 11040 (Debridement; skin, partial thickness) into 16020 (Dressings and/or debridement of partial thickness burns, initial or subsequent; small [less than 5 percent total body surface area]), 16025 (… medium [e.g., whole face or whole extremity, …
Held Up Medical Billing Claim? It Might Be the Zip Code
At the beginning of 2007; medical billing claims that are submitted to Medicare for reimbursement need to have a zip code or you can count on a delay. A National Provider Identifier requirement to include your zip code on all billing transactions took effect Jan. 1. This included all bills including RAPs, and providers must report a five or nine-digit zip code for their primary facility and its subparts. Claims without the zip codes will be returned to provider (RTP’d) with reason code 32114. This will affect any facility that does medical billing claims for Medicare reimbursement. Many providers were unaware of the new requirement and a large amount of …
When to Provide Family and PH V Codes
With all of the various codes that make up medical coding, it can be confusing when you’re separating out closely related codes to find the best fit for your medical billing claim. One situation is when it comes to figuring out the difference between both personal and family history V codes. Basically, what you need to remember is that the V codes are there to help give a window into past patient history. If there is an ongoing medical condition, the V codes can be used to tell the tale. When looking into personal history, you can find out more about any prior procedures, hospitalizations and operations, as well as …
Knowing When It is Time to Outsource Your Medical Billing
It’s hard to let go of what you might deem the financial control of your practice. Hiring a medical billing consultant can seem like you’re adding expenses instead of cutting them down, especially if you have never outsourced your billing. If you’ve always discounted outsourcing your medical billing claims because you feel as though you would be relinquishing control over your billing, read on – you’ll find that is not the case. Actually outsourcing your medical billing and coding needs through a consultant is one of the smartest business moves you can make. Don’t think you have to use a local company, many medical billing firms have branch offices in …
