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.
Separate Medical Billing For Separate Tests
Separate Medical Billing For Separate Tests The Centers for Medicare & Medicaid Services has improved medical billing reimbursement for Medicare patients. Currently, if your practice does medical billing for a Medicare exam on a newly 65 patient, you can also bill for cardiovascular screening tests and diabetes screening tests. The Centers for Medicare & Medicaid Services realizes that separately billing for these screening services may seem incorrect. For this reason they are sending out plenty of medical billing information to explain how to bill for preventative care in the future. For instance, one of the things physicians can bill for separately is diabetes screening tests. As long as one risk …
Appeal When A New Code Claim Isn’t Paid?
Should You Appeal When A New Code Claim Isn’t Paid? HIPAA regulations are in place to prevent medical billing games. When current procedural terminology codes and ICD-9 codes are introduced, they have a certain effective date attached to them. This effective date states the very last day in which payers and providers must recognize the new code. It is illegal to deny claims for medical billing non-recognition. Providers deny claims all the time. There are various reasons for claim denials. These can range from a non covered service, to not substantiating medical necessity for a service. However, it is against the rules to deny medical billing because their system doesn’t …
Guideline Changes For Portable X-Rays
Guideline Changes For Portable X-Rays Portable x-ray medical billing is quickly changing. Currently, separate modifiers and medical billing codes are used for transportation of these x-rays when claims are sent to insurance carriers and Medicare fiscal intermediaries. On April 1, 2006, different codes will not be used. Medical billing codes sent to all payers for portable x-rays will be the same. The correct way to do medical billing for a portable x-ray transportation is to use modifiers. The Medicare fiscal intermediaries require a skilled nursing facility to use modifiers when more than one patient is treated after portable x-ray equipment is transported. The Centers for Medicare & Medicaid Services state …
ICD Changes That Will Affect Some Medical Billing
ICD Changes That Will Affect Some Medical Billing In an effort to improve medical billing and patient health, it is now a requirement to enroll in the new ICD (implantable cardioverter defibrillator) data repository. On October 27, the Centers for Medicare & Medicaid Services announced they would be moving over to a new data system. The purpose of this transition is to improve cardiovascular knowledge. Increased cardiovascular knowledge will lower bills and improve medical billing. The New ICD data repository for the Centers for Medicare & Medicaid Services will be a change for the better. With all medical billing information transitioning from the old system, Quality Network Exchange ICD Abstract …
Medical Billing For An Unlisted Procedure
Medical Billing For An Unlisted Procedure Have you ever heard of a jejunostomy in medical billing? Probably not, because this procedure is not listed under any current procedural terminology codes. The service is similar to a gastrostomy, but slightly different in nature. The question becomes: Should you use a gastrostomy CPT medical billing code when the service is actually for a jejunostomy? A medical billing guideline would answer this question. It is not acceptable to choose the “next best” code when an exact code will not work for a service. Medical billing should be completely accurate. If there is not suitable code to describe the service, you should report the …
Better Training, Better Billing, Better Reimbursement
Better Training, Better Billing, Better Reimbursement Medical billing staff members should be highly skilled. The better the training, the more accurate your claims and reimbursements will be. Medicare Part A can be difficult for even the most skilled medical billing staff members to grasp. There are some simple things any medical billing personnel should know about Medicare Part A. Any mistake in the medical billing arena can not only cost you big bucks, but can also get you tangled up in the law. It is important to make sure your staff members understand consolidated billing for Part A. There are many things that are only excluded in Part A when …
What Does A Non-compliance Claim Really Do?
What Does A Non-compliance Claim Really Do? If you think medical billing non-compliance is something that you can forget, think again. Nursing homes, especially, may see more instances of past non-compliance issues coming back to haunt them. Not only do you need to be aware of current compliant issues, but keep track of your old non-compliant instances as well. The Centers for Medicare & Medicaid Services announced that state surveyors should not only investigate current noncompliance medical billing issues, but also past noncompliance. This means that if a surveyor comes to your nursing home for a visit, your past medical billing noncompliant issues may come back to haunt you. The …
OB-Gyn Medical Billing – Bundling OB-Gyn Claims
OB-Gyn Medical Billing – Bundling OB-Gyn Claims In medical billing, there are many Ob-Gyn codes that should be bundled, while others should not be bundled. The current procedural codes 58720 and 57283 frequently bring up this bundling question in medical billing. It is important to know when to bundling certain Ob-Gyn medical billing codes and when to bill them separately. The current procedural terminology code 58720 (Salpingo oophorectomy, complete or partial, unilateral or bilateral) can be billed completely separately from a colpopexy (57283). This means that if your physician does both of these services at the same time, you can do medical billing for both procedures. There is no bundling. …
New Codes For Home Health Medical Billing
New Codes For Home Health Medical Billing The Home Health consolidated medical billing list is being updated. In an effort to smooth out the changes of moving to a new coding system, there have been some new home health service codes added to the repertoire. In addition to five new medical billing codes, there will be three supply home health consolidated billing codes that will disappear. The Centers for Medicare & Medicaid services have made it clear that home health services are not being redefined. The services still mean the same things. The only reason medical billing consolidated codes are being added and dropped is due to the new coding …
Avoiding Fraud and Abuse Charges in Medical Billing
Avoiding Fraud and Abuse Charges in Medical Billing Gainsharing in medical billing is highly scrutinized. The HHC Office of Inspector General is very suspicious about gainsharing activities with healthcare providers. There are three areas hospitals should focus on in order to prevent medical billing fraud allegations. Improper gainsharing agreements are borderline fraud in medical billings. The three things hospitals can do to prevent any fraud charges are having sufficient quality controls implemented, promoting accountability, and limiting payments that lead to referral pattern changes. If all three of these elements are satisfied, your hospital will have no problem providing trustworthy medical billing. Currently there is a CMP (civil monetary penalty) that …
