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.
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 …
Why Medical Billing Claims Get Denied?
There are a number of reasons that your medical billing claims could be getting kicked back. Next time you have a medical billing claim kicked back, carefully check it to see why it was returned. Finding out why your medical billing claims were refused will sometimes uncover an unhealthy pattern in your office such as not keeping up with the changes to the CPT codes. And that’s our number one reason, usage of outdated or improper codes. The CPT updates a number of times a year and keeping up with those changes can be difficult. However, if you don’t use the most current coding the carriers are well within their …
The Answer For a Busy Staff
Very little can compare to how busy a doctor’s office can get. Besides the patients that you have scheduled, your staff will also have to handle endless phone calls, questions from patients and potential patients, patients without appointments that simply walk in and emergency and urgent care situations that require other patients be re-scheduled so an urgent matter can be performed. Along with the patient care and servicing come the day-to-day office duties that include coding your medical billing claims correctly, keeping up with the CPT codes, knowing which modifiers to attach to which claims, making sure that your practice is credentialed to be servicing patients that have other insurances, …
The Benefits of Getting Credentialed
One thing you learn quickly when you establish your own practice is that there are many types of insurance plans as there are patients and in order to get paid for the services that your render, you must be approved or rather “credentialed” to do business with your patient through that particular insurance company. The process of getting credentialed with each insurance company is a little different as to what each carrier will require from you but each will require a lot of paperwork and following up. That’s where a third party partner can help you.If you want to get credentialed with as many different carriers as possible but you …
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 …
