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.
Deciding to Use Modifier 59 on Certain Procedures
Sometimes in medical billing it is difficult to decide when to use current procedural terminology codes 58661 and 49322-59. These codes, like many others seem similar, but in actuality, are quite different. When performing medical billing it is necessary to know when to use current procedural terminology code 58661 versus 49322-59. The medical billing code 58661 (laparoscopy, surgical; with removal of adnexal structures) is used when any part of the ovaries or Fallopian tubes are removed. For example, If a surgeon was doing a cystectomy of an ovarian cyst and ended up removing some of the ovary as well, they physician could do medical billing with 58661. The current procedural …
When New Billing Codes Aren’t Recognized
In medical billing, code recognition is not the only reason for denial. If a claim containing a new code is denied, go through your medical billing claim and make sure it is absolutely accurate. Then you can probably narrow down the reason to simply a matter of the carrier not recognizing the CPT code. When new medical billing codes are introduced there is a lag period that lets coders and payers get adjusted for that specific code. HIPPAA sets an effective date for all medical billing codes that states when companies must begin using the codes or accepting the new codes. It is illegal to deny claims for no recognition …
The 4 Big Myths of OB-Gyn Medical Billing
OB-Gyn medical billing can be very confusing and some physcians will under code their medical billing claims as they fear an audit so they don’t submit full claims but in fact, this practice will cost you money. In order to understand OB-Gyn billing fully, you must understand the myths associated. There are four medical billing myths associated with OB-Gyn medical billing that may be holding back your reimbursements. The first myth deals with the initiation of the ob record. If both the ob-gyn and the nurse see the patient for initial blood work, you should not report a minimal code for both instances. In OB medical billing, you should report …
Making Inpatient Reporting Easy
One of the most difficult medical billing feats is inpatient consultation coding. There are many instances when a follow-up inpatient consult should be replaced by a subsequent hospital care visit. To eliminate these medical billing errors, there are four facts to consider when coding for inpatient consults. The first fact is very obvious. If your report an inpatient consultation exam, the patient must be inpatient, not outpatient. Very often physicians see patients on a consultation basis when they are outpatient. Medical billing mistakes can be made easily. Double check your work. It is important in medical billing to always report one initial consultation. This code will correspond with the very …
Better Medical Billing For MRI Claims
Medical billing hip MRI rules are not as straightforward as you might assume. There are many variations on how to correcting bill for this service. There are some facts you should keep in mind when doing medical billing for lower extremity MRIs. Unfortunately, there is no specific medical billing CPT code for an MRI of the hip. You need to use the codes 73721-73723 (Magnetic resonance imaging, any joint of lower extremity). The hip joint falls into this medical billing category because it is a lower extremity joint. Doing medical billing for bilateral hip MRIs is also a bit more complicated. Different payers require different modifiers for payment. For example, …
Medical Billing Once or Twice for Certain Codes
Patient evaluation codings can be very confusing. The patient initial evaluation code is 97001 (also, 97003, 92506, 92610) however if the patient is reevaluated (97002- patient reevaluation) within a 12 month period only one unit of service may be billed to Medicare Part B patients no matter how much time was spent actually servicing the patient. If you make a mistake and bill the carrier for the evaluation and a unit of service for the reevaluation, your claim will be denied based on incorrect coding no matter how much medical documentation you provide showing the necessity of the reevaluation of the patient. Keeping up with the fast paced changes of …
Don’t Make a Bad Choice With a Medical Billing Partner
When you’re considering outsourcing your medical billing from your practice to a third party partner, it pays to look around and find the best fit for the needs of your individual practice. Be aware that the best choice may not be around the corner or even in the same state as your practice. With the security of Internet transmissions, you can use a company across the country and be just as secure as if you were handing your documentation directly to someone across the hall from you. Making the choice to use a medical billing company for your practice can save plenty of money. However, choosing the wrong medical billing …
Medical Billing – Beginning With the Basics
It starts with a patient who sees a physician. The patient gives the office their insurance or Medicare card and a new medical billing form is generated. No matter what procedures are rendered to the patient, it will be documented in the form of numbers called CPT codes, on the medical billing form. If the patient has any testing done such as a blood or urine sample, basic evaluation or even a patient history interview, all of this including if the patient is a first time visit or not will be documented on the medical billing form. If there is a reason for the patient not feeling well such as …
Reimbursements For Therapy Medical Billing
One of the biggest eyebrow raisers for carriers as far as medical billing claims go are any claim submitted for reimbursement for therapy based medical billing claims. Most therapy claims are 100% legitimate but because of the amount of fraud that has been perpetrated by a few unscrupulous individuals all of these types of claims get closer looks than ever. One way to insure your claims are submitted correctly is to make sure the documentation is done absolutely accurately in your therapy department. In a recent audit of claims, the CMS found that the number one error in reporting therapy medical billing claims is with the minutes billed. Make sure …
Don’t Make Mistakes On Admission Codes
As you know, a hospital admission requires face-to-face service. However a common dilemma that many medical billers find themselves in is when a surgeon “admits” the patient and then isn’t present when the patient arrives at the hospital to check in. In most cases the physician will dictate the history and physical (H&P) over the phone to the hospital and then send the patient over, however the dilemma for the medical billing occurs over the fact that the face-to-face interaction between physician and patient doesn’t occur until the following day. First of all, your dates must correspond. If the physician doesn’t see the patient in the hospital that day (performing …
