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.
Selective Debridement Medical Billing Reimbursement Doubtful
Selective Debridement Medical Billing Reimbursement Doubtful Lately debridement medical billing has brought up many questions in the healthcare industry. The medical billing CPT codes 97597-97598 can usually not be used by every provider. The American medical association Recently released these new Current Procedural Terminology codes. Interpretation of these two medical billing codes varies from payer to payer. When the American Medical Association first released the codes 97597-97598 there was a lot of confusion. Shortly after that release the Centers for Medicare and Medicaid Services offered an explanation of the medical billing codes. 97597 (Removal of devitalized tissue from wounds, selective, debridement, without anesthesia, with or without topical applications, wound assessment, …
Using Cross-Subsidizing in Medical Billing Could Lead to Denials
Using Cross-Subsidizing in Medical Billing Could Lead to Denials Using your medical billing to cross subsidize lesser expensive services with more profitable services could lead to denials. Some hospitals are already feeling the pain. A revamp in hospitals’ medical billing chargemaster may be in order to correct this reimbursement problem. In the coming months the Centers for Medicare and Medicaid services will be doing a more detailed look at your hospital claims. If you happen to be cross subsidizing the more profitable services for the less profitable services, this may lead to non payments. This will change the medical billing scene forever. Unfortunately if insurance companies quit paying your medical …
Medical Billing Changes at Blues
Medical Billing Changes at Blues In an effort to reduce medical billing expenditures, Blue Cross Blue Shield is implementing a couple programs. Each one of these programs improves the healthcare and well being of its members. They also reduce medical billing reimbursement costs to Blue Cross Blue Shield. Your practice does everything to raise medical billing reimbursement, Blue Cross Blue Shield does everything in its power to lower reimbursement. One of the ways Blue Cross Blue Shield is lowering medical billing expenditures is in Kansas City. There is a pilot program where members/patients can use the Internet to contact Physicians and asked medical questions. This is not intended for emergency …
Medical Billing Modifier 56 Pitfall
Medical Billing Modifier 56 Pitfall Using modifier 56 in a medical billing preoperative consult can be used by a specialist or even a primary care physician. Many people believe specialists are only allowed to perform consultations. This is incorrect thinking. If done correctly medical billing reimbursement is allowed for family care practice consultations. There are two main situations in which a family care physician would perform a consultation in medical billing. The first, and the most common scenario, is when a surgeon requests that a family practice physician examines their patient prior to surgery. They would do this to make sure the patient is healthy enough to undergo the specific …
Surefire Medical Billing Tips for Modifier 25
Surefire Medical Billing Tips for Modifier 25 Modifier 25 is a medical billing code used to indicate extra work for a medical service or procedure. Soon, the American Medical Association (AMA) will explain in more detail the correct way to use this modifier. Before then, there are three simple steps you can use to learn how to correctly use the medical billing modifier 25. The first medical billing step to correctly use modifier 25 is to only report the most significant services provided during the visit. When reporting an Evaluation and management exam, it is very difficult to perform a service that is separately billable. Most things are covered under …
Changes To Your CCR
If you have a New Provider Number you can expect Changes To Your CCR Your CCR or cost to charge ratio will still be used with the surviving provider number if your hospital merges with another one. Your Medicare fiscal intermediary will continue to use the old CCR instead of a new one if there is a merger. However, If Medicare issues the hospitals a new provider number after a merger then there will be a different outcome. In the event of a new provider number your Medicare fiscal intermediary will use the average CCR for the state because according to them a new provider number means that there has …
Medical Billing Expanded for Cardiac Rehab
Medical Billing Expanded for Cardiac Rehab Cardiac rehabilitation staff members have great medical billing news coming their way. The Centers for Medicare and Medicaid Services expanded coverage for cardiac rehab this past December. The medical billing element for cardiac rehabilitation will be much less strict when it comes to requirements. Last 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 …
Flu Shot Frauder May Pay for Medical Billing Misuse
Flu Shot Frauder May Pay for Medical Billing Misuse If you thought you had medical billing problems, check out the problems in Houston! Currently, Texas is home to one of the most outrageous medical billing fraud cases. Two individuals are accused of administering fake flu shots to individuals and getting medical billing reimbursement for these fake services. Two individuals, Ivad Abu El Hawa and Martha Denise Gonzales were involved in this serious medical billing fraud. Hawa is the owner of Comfort & Caring Home Health, which is located in Houston. Gonzales is the manager of a Houston Doctor’s office. Apparently, the two gave 1,100 people employed by Exxon Mobil fake …
3 Steps For Getting the Indirect Supervision Code
3 Steps For Getting the Indirect Supervision Code For help with performing the care plan oversight services if you are having a hard time with the 993xx series these steps should help to get you started. Step one is to count these care services as 99374-99380. The 993xx series codes allows pediatricians to bill for coordination of care of special needs children without face to face visits. You can report these care plan oversight CPO codes as 99374-99380 for Doctor supervision. This is only for when the patient is not present for the following doctors services, a) revision or development of care plans for multidisciplinary and complex modalities. b) related …
New Solution for Therapy Medical Billing Caps
New Solution for Therapy Medical Billing Caps New treatment methods and less surgical procedures has made therapy medical billing dramatically rise. Not only are there more physical therapy claims, but there are also many more speech therapy and rehab claims sent in to payers. To decrease the deficit, the House of Representatives recently passed an act that puts a cap on therapy medical billing. The Deficit Reduction Act of 2005 was passed on December 21,2005 with a very narrow vote by the Senate. Senators were split in a 51-50 vote to cap therapy medical billing reimbursements. As a matter of fact, the vice president of the senate cast the tie …
