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.
Correct Diagnosis and Dressing Medical Billing And Coding
The correct medical billing code for attending to surgical sutures is fuzzy. Currently the regional home health intermediary is closely examining the use of the code V58.3 (attention to surgical dressings and sutures). Medical billing constantly changes and the close examination of V58.3 is a perfect example of this statement. The medical billing question is whether or not V58.3 is a suitable primary diagnosis code. The Regional home health intermediary is pulling claims with this diagnosis code and reviewing them for medical necessity. The decision on how to use V58.3 correctly in medical billing will be released once the examination is completed. Since changes to procedures and policies are quite …
Be Aware of New Down Syndrome Screening in Your Medical Billing
Constant changes in medical care means constant changes in the medical billing world. One area of medicine that is constantly analyzed and improved upon is that of prenatal care. A new screening test for Down Syndrome may give parents sooner knowledge of their baby’s condition. Medical billing must always reflect the current changes in medicine. The new test for Down Syndrome allows mothers to get their fetuses tested in the first trimester of pregnancy. This test includes a blood sample and an ultrasound. That means your medical billing codes need to accurately reflect the new services provided. Apparently, the new Down Syndrome screening method more accurately diagnoses the disease than …
The Government’s Attempt at Simplifying Medical Billing
Although you may think so, the federal government is not out to get your medical billing department. The government has been and is making conscious decisions that will positively impact the way you go about your business. The goal of the Department of Health and Human Services (HHS) is to make your medical billing as efficient as possible. The Department of Health and Human Services realize that there are some medical billing regulations in place that may hinder your efficiency and quality of care. They want your practice to be as profitable as possible while you give the best care as possible to your patients. With current medical billing regulations, …
HIPAA And Code Sets
Imagine this scenario: What if your medical billing claims were suddenly rejected at a rate of up to 25%. Sound like a nightmare? You bet it does,but it could happen to your practice if you don’t keep up with HIPAA regulations and current coding changes that occur many times per year. That is a huge chunk taken out of your reimbursement revenue, and could easily be avoided through proper filing of your medical billing claims. On Oct. 16, 2003, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) took effect and with that a new set of standards for the transactions and code sets that you use every day …
Medicare To Verify Necessity Of More Medical Billing Claims
There is currently a medical billing demonstration taking place that may lead to increased medical necessity reviews. Currently, the states of New York, California, and Florida are involved in a pilot demonstration led by the Centers for Medicare & Medicaid Services. The Centers for Medicare & Medicaid Services has hired a Recovery Audit Contractor (RAC) to do extensive evaluation of medical billing claims for three years. You may be asking: What does this medical billing audit mean to your practice? If the demonstration in these three states is successful and the Centers for Medicare & Medicaid Services are able to recover money in medical billing overpayments, it could mean a …
How Your Neighbor’s Cost Report Can Cost Your Medical Billing
If you thought your IPPS (inpatient prospective payment system) has nothing to do with medical billing and reimbursement, then think again. Not only will your 2003 IPPS effect your own medical billing, but now your neighbor’s IPPS will effect your 2007 reimbursement as well. The Centers for Medicare & Medicaid Services announced that they will use the 2003 hospital medical billing index data to figure the 2007 payments. That means that if you were not completely accurate with your IPPS, then your reimbursements in 2007 will be skewed. CMS also announced that they will only calculate one wage per state for hospitals outside of the core-based statistical areas. This means …
Inpatient Medical Billing Consultant Choices Diminish in 2006
For a long time there has been a confusion about when to use inpatient follow-up consultation codes. In 2006, this will no longer be an issue, there will only be one type of inpatient consultation service: initial and subsequent. Follow up inpatient consultation codes will no longer be used in medical billing. The previous method when doing medical billing for inpatient follow up consultation codes was to use 99261-99263 (Follow-up inpatient consultation for an established patient). Unfortunately, physicians and medical billing staff members found it difficult to decide if the care was initial or a follow-up. Those CPT codes were constantly claimed incorrectly. In an effort to increase coding efficiency …
Decertification Could Cost You Big in Medical Billing
Keep accurate medical billing and policy practices to ensure your facility’s success. Certification is a necessity tool if you run a Hospice. If you happened to lose that certification for any reason, you would lose out on a lot of revenue. Just ask VistaCare how much they have lost in medical billing since being decertified in October. VistaCare Inc. is a Hospice care facility that was decertified in the two cities of Indianapolis and Terre Haute in October. Since then, they have attempted to assist over 100 patients without pay. Medical billing has been put on hold while they figure out a solution. The solution to the VistaCare Inc. problem …
How Can Physician Credentialing Benefit Your Practice?
Did you think your medical billing partner only handled your coding and medical billing claims? Another service we provide is physician credentialing. You have a busy practice and your staff is just as busy servicing your patients and answering the phones. You really don’t have time these days to fill out yes another form to get yourself credentialed to do business with yet another insurance carrier. You know from previous experience that getting yourself credentialed to do business with certain carriers can take months as the processing of that paperwork can be a slow process unless you are calling the carrier every few days for a status and if you …
CCR Changes for A New Provider
If you are merging hospitals, your medical billing numbers may change. Provider tax identification numbers are used to identify hospitals and medical practices. When one hospital merges with another hospital, the capital cost-to-charge ratio will change for one or both hospitals in medical billing. The first scenario in medical billing is when two hospitals merge and use one of the hospital’s tax identification number. This means that the other hospital drops their own medical billing number. When this happens, Medicare uses the hospital with the existing tax identification number to figure capital cost-to-charge ratios. The second medical billing scenario is when two hospitals merge and get a new provider number …
