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.
About 99053 and 99058 for your Medical Billing
There are new codes issued in the CPT 2006 that specifically designate 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 new limitation on using late night service codes. Previously a coder would have simply used 99052 …
In the Beginning of Medical Billing: Medical Coding
Many people assume that medical billing and medical coding are one in the same procedure. However as you in the industry know, they are part of the same process, but very different. Medical coding is where medical billing begins and couldn’t be processed without it. When a physician or hospital renders services, a code is assigned to that procedure or procedures. The more services that are performed for a patient, the more medical billing codes there will be. Those codes are recorded on a medical billing form. The tricky part is keeping up with the ever-changing nature of the medical billing codes. These codes can be changed/added to/or removed many …
Correct Medical Billing for Foreign-Body Removal
Foreign body removal is another scenario that winds up with a lot of rejections or reduced reimbursements. One of the biggest reasons is that when the coding is being done on the claim. The part of the body affected isn’t addressed in the medical billing claim. If a foreign body was removed from a patient’s eye, then the code for simple foreign body removal should not be used. The specific coding for removal of conjunctival foreign bodies which is code 65205 (Removal of foreign body, external eye; conjunctival superficial) or 65210 (conjunctival embedded [includes concretions], subconjunctival, or scleral nonperforating). Notice that these codes do not refer to any particular instrument …
Medical Billing for Ob-Gyn Claims Made Easy
As you know, the CPT 2006 injection coding instructions now require that the ob-gyn’s presence be verified during an injection which is coded as 90772 or the procedure must be reported as a non nonphysician-performed procedure as 99211. The latter can result in a no-charge depending on the payer’s policies. You need to make sure you answer these questions: *Is the Doctor in the office and available at the time of injection?If you can answer yes, you can report this medical billing claim as 90772. If you cannot answer yes, then you have to use 99211 that is for injections given without direct physician supervision. The requirement does not mean …
Extensive Documentation for Chiropractors and Podiatrists
Medicare is recommending that chiropractors and podiatrists claims get extra-close scrutiny in their latest issue of the Red Book, which has recommendations for saving Medicare and other federally funded programs money. There will be more stringent requirements for chiropractors to meet for certain procedures and debridement services performed by podiatrists will be getting looked at very closely. If you perform these services or your are a medical billing company that does, check and double check your medical billing for the proper documentation before filing your claims to avoid delays in reimbursements or outright rejections of your medical billing claims. The modifiers used on these claims will be getting extra close …
Consolidating Your Medical Billing Lists
The Home Health Consolidated medical billing lists are currently changing. This new change comes about because the medical coding system is quickly changing and can no longer support certain medical codes and needs other medical billing codes for consistency. Be sure to update your medical billing consolidated lists with these new home health codes for accurate claim submission. There are three medical billing codes for home health that will be eliminated from the consolidated list. These codes include A5119 (Skin barrier wipes box pr), A6025 (Gel Sheet for dermal or epidermal application), and A4656 (Needle, any size each). Two of the codes, A5119 and A4656, will be replaced with more …
Thinking of Hiring a Medical Billing Consultant?
It can seem daunting to hire a medical billing consultant. Especially if you have never outsourced your billing or you feel as though you would be relinquishing control over your billing which is not the case. In reality, 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 an area near you, but others may be miles to hundreds of miles away, and thanks to the power of the internet with secure connections and software advances that allow you to transfer your patient …
Use Correct Coding For Best Power Mobility Device Reimbursements
There are some strict medical billing requirements for power mobility devices now a days. These requirements, however, don’t come free. Now Medicare and other payers will have to pay your physician for his/her time spent working on extra documentation for these devices. You can expect an extra $21.60 for your extra time spent on power mobility medical billing. Recently there was an increase in the amount of documentation that is needed to do medical billing for power mobility devices. Medicare requires the prescription, patient’s medical records, and any other supporting information. This medical billing process was and is extremely time consuming. The Centers for Medicare and Medicaid Services realized this …
ADD/ADHD Medical Billing Reimbursements
Attention providers, are you getting reimbursed for your medical billing ADD medication rechecks? With the rise of ADD/ADHD in America, it is very important to medical practices to understand how to get paid. When dealing with mental health diagnoses, you walk a fine line with most insurance companies. There is one way most payers will reimburse your ADD/ADHD medical billing. Most physicians like to code ADD medication rechecks with the 90862 medical billing code. This code means, pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy. Although there is no problem using this CPT code with the diagnosis 314. (Hyperkinetic syndrome of childhood), …
Avoid Fraud and Abuse Charges With Careful Gainsharing
Gainsharing may be beneficial for your bottom line in medical billing, but it raises a lot of suspicion for the Centers for Medicare & Medicaid Services. The HHR Office of Inspector General believes gainsharing can be questionable because it can violate anti-kickback policy, and the Stark Law. The Office of Inspector General states there are three fraud safeguards to use when using gainsharing medical billing. First, when utilizing gainsharing arrangements, you should be sure your organization promotes accountability. If you are accountable for your policies and medical billing procedures, you look a lot less suspicious. Another gainsharing safeguard to use is to limit any payment that could change referral patterns. …
