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.

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Hiring a Medical Billing Consultant?

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

By: Kathryn E, CCS-P - Retired on January 19, 2007

The Basics of Outsourcing Your Medical Billing?

If you’re wondering how your medical billing gets to the outsourcing company, the answer is carefully and securely. The patients are seen as usual in your office, your staff creates the records for billing just as they always did. If you are still using paper files your claims will need to be scanned and hand entered into the medical billing system, if you transmit electronically your staff will need to only access the program and transmit the chosen claims to be processed by the medical billing company. The data will be transmitted to the medical billing company who will code and double check your medical billing claims to insure they

By: Kathryn E, CCS-P - Retired on January 18, 2007

How Private Is Outsourcing Your Medical Billing?

Confidentiality is a big concern in every corner of the medical community. Now that you’ve done your homework, you know outsourcing your medical billing is good for your practice and good for your staff. You know Electronic Claims Filing is the best way to file your medical billing claims, but you have concerns about exactly how private sending your medical billing out of your office to a third party might be. Privacy and security have become major issues for those in the medical profession and for the companies that handle your medical billing and coding. Rest assured, your claims are handled in complete confidence and your patient’s privacy is secured

By: Kathryn E, CCS-P - Retired on January 17, 2007

Can DME/HME Be a Profitable Venture For Your Practice?

Even two years ago the answer to that question might have been “no”. However, in 2007 it might well worth looking into for your practice. Previously, the cost of the products versus having to track claims, find reimbursements, and keep up with claims status; made DME a very labor intensive venture. With the advent of specialized DME/HME software, secure internet connections, and standardized billing procedures; DME can now be a very profitable venture. In your practice, you will want to be sure that the product(s) you are dispensing are profitable. You need to watch the pricing of the product costs, in some instances, your product costs may be more than

By: Melissa C. - OMG, LLC. CEO on January 16, 2007

Avoid Under-Billing Neonatal Services

Under-reporting medical billing claims is unfortunately common and it costs revenue as you’re not being fully reimbursed for services rendered. Learning the exceptions to the bundles will allow you to break out services that can be billed alone – once you start investigating neonatal services you’ll realize quickly that you may have very been missing legitimate reimbursements. A scenario that isn’t uncommon is when a doctor attends a delivery of a 28-week gestation baby. The infant received positive pressure ventilation (PPV) in the delivery room (DR) with mask and bag for absent respiratory effort at birth. The baby was then intubated in the delivery room and received PPV on transfer

By: Melissa C. - OMG, LLC. CEO on January 12, 2007

Keeping Up With Medical Billing Changes

January 2007 brought more changes to the medical billing industry. Certain codes were “retired”, new codes were added and others simply had their meanings broadened to encompass their meanings. If your practice doesn’t keep up with the changes and know in advance of coming changes, you can be losing out on legitimate revenue for services rendered. Some practices are losing up to one fourth of their revenue simply because they staff isn’t aware of the best techniques for reporting procedures. Undercoding is another way many practices don’t get the full value for their services. If your staff is undercoding your medical billing claims you are definitely missing out on reimbursements.

By: Melissa C. - OMG, LLC. CEO on January 11, 2007

Critical Care NCCI Edits For 2007

NCCI has some important updates for 2007, If you need to report an emergency department (ED) visit as well as a critical care code (99291), you should keep in mind that a bundle, care of the National Correct Coding Initiative (NCCI), version 12.3, prevents you from reporting both. The code range that you should be aware of is 99281-99285 alongside critical care code 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes). The ED visit is now a component to the comprehensive critical care service with the new NCCI edit, you can’t separate this with a modifier. There are currently no known

By: Melissa C. - OMG, LLC. CEO on January 10, 2007

Medical Billing To Differentiate Between Facial and Dental Nerve Blocks

When you have a procedure that can cover two close but distinctly different areas such as a facial and a dental nerve block, you need to make sure that your claim encompasses exactly the procedure that was done or you may wind up with a denial of your claim. A common situation would be if the ED physician performed a diagnostic nerve block on a patient complaining of pain in the floor of her mouth and her bottom set of teeth. You would want to be certain that you chose 64402 (Injection, anesthetic agent; facial nerve) for facial nerve blocks, not blocks in the mouth or jaw. The determining factor

By: Kathryn E, CCS-P - Retired on January 9, 2007

Medical Billing For Mastectomy and Lymph Excision

When the surgeon removes lymph nodes during a partial mastectomy, it may be confusing as to how to the mastectomy and the lymph excision. A common point of confusion is whether they should be bundled or reported separately. The answer is pretty cut and dried. In most cases, with partial mastectomy, the surgeon will perform an axillary lymphadenectomy to remove the lymph nodes between the pectoralis major and the pectoralis minor muscles. The surgeon may also remove the nodes in the axilla through a separate incision at the same time. When this occurs, you should not report the mastectomy and lymphadenectomy (38745, Axillary lymphadenectomy; complete) separately. Instead, you should use

By: Kathryn E, CCS-P - Retired on January 9, 2007

Reporting Your Ulcer Treatment Claims Correctly

Often, patients who are confined to beds for long periods of time develop pressure ulcers. They are painful and need to be treated as quickly as possible as infections can set up within them that can be life threatening when the patient is already in a weakened condition. When a service is performed for a patient such as treatment of a pressure ulcer on an area of the body such as the lower back, the usual manner of treatment is to remove any devitalized tissue from the ulcer using a water jet and forceps. The area is then covered to allow it to not be rubbed on so the skin

By: Melissa C. - OMG, LLC. CEO on January 5, 2007