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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CPT Code 99211 In Medical Billing

CPT Code 99211 In Medical Billing Understanding when to use CPT code 99211 on your medical billing can boost your practice’s revenue and improve documentation which will result in greater returns on your reimbursements. Qualifying for 99211 service on your medical billing is not too hard, the patient simply must be established, and an E/M service must be provided. Additionally, the service must be separate from other services performed on the same date and neither the presence of a physician nor any documentation of key components are required as part of the documentation for the medical billing. Another use for Code 99211 is patient education, simple rechecks, medication reviews and

By: Melissa C. - OMG, LLC. CEO on August 31, 2005

ICD-9 Coding Accuracy In Your Medical Billing

ICD-9 Coding Accuracy In Your Medical Billing When you talk about the procedures you do and services you perform for your patients, you have words to describe what you did: patient eval, Pap smear, sinusitis. When third-party payers examine and refer to the work you do, it’s simply broken down into numbers. Almost every medical condition, service and supply can be identified by a numeric code, primarily because Medicare and other third-party payers require numeric coding on claim forms. They set the payment rules, based on these codes so the proper coding must be used so your practice can be reimbursed for your services. It’s not easy to being fluent

By: Melissa C. - OMG, LLC. CEO on August 31, 2005

Top Five Types of Service Most Frequently Appealed

Top Five Types of Service Most Frequently Appealed A recent study conducted by Medicare showed that the top five types of services submitted on medical billing forms for payment fell under the following five catagories. Evaluation and Management – 99200-99499;Pathology & Laboratory – 80000-89399,G0001,P0000-P9999;Radiology – 70000-79999, G0130-G0133, G0236;Ambulance – A0000-A0999;Chiropractic Manipulative Treatment – 98940-98943.Most of these claims were submitted directly by physicians’ offices and not by medical billing firms. As you are aware, evaluation and management, pathology and laboratory and radiology services are all high volume procedures but with the levels frequency for these procedures the medical billing should be able to be more streamlined for most offices. Your medical

By: Melissa C. - OMG, LLC. CEO on August 30, 2005

To Ask About Electronic Medical Records Software

Important Questions To Ask About Electronic Medical Records Software If you’re a private physician, you have probably looked at more electronic medical records (EMR) programs than you care to remember. When looking at EMRs there are a number of questions you should ask: What is the licensing of this product? Meaning do you have to pay every time you load it on a computer in your office; so you and your secretary and office manager can all handle billing?. Some companies have a site license for which you can put your EMR software on a number of PC’s in your office without restrictions on program users. Other software is sold

By: Melissa C. - OMG, LLC. CEO on August 30, 2005

Changes In The Medical Billing World for July 2005

Changes In The Medical Billing World for July 2005 In July 2005, for many states, there was a 2% rate increase in Physical Therapy, Occupational Therapy and Speech/Language Pathology. As of July 1, 2005 the provider is responsible for submitting the correct charges for dates of service on or after July 1, 2005. If you have submitted medical billing claims before notification of this increase (if it applies in your state),you must submit an adjusted medical billing claim to receive the new rate. Additionally, Colorado Home Health and Home and Community Based Services Providers as of July 1, 2005, may no longer submit claims for HCBS services under their Home

By: Melissa C. - OMG, LLC. CEO on August 29, 2005

4 Reasons To Outsource Your Medical Billing

4 Reasons To Outsource Your Medical Billing There are many good reasons that you can be given for outsourcing your medical billing to an outside source, there are 7 main points that will make you realize how much outsourcing your medical billing can save your practice in terms of not only your bottom line, but time as well. Reason #1 – Your staff will have more time to help run your practice.Your practice is busy, your staff doesn’t have time to stop and look up a claim status, double check coding on the medical billing forms or look up additional coding that may be necessary to outline procedures performed. Your

By: Melissa C. - OMG, LLC. CEO on August 29, 2005

Have You Ever Thought Of Medical Billing As A Career?

Have You Ever Thought Of Medical Billing As A Career? If you’re looking for a change in your career or you want to jump back into the workforce with some training that will benefit you, becoming a Medical Billing Specialist is a fantastic way to accomplish your goals. As of 2004, The American Medical Association estimates that there are 1.2 million medical billing specialist in the workforce today, and more jobs are expected as the population continues to age. The most wonderful part of being a medical billing specialist is that you can work in a doctor’s office, a clinic or work with a company that handles medical billing for

By: Melissa C. - OMG, LLC. CEO on August 28, 2005

Coding Radiology Services

Coding Radiology Services Medical coding for radiology services can be very tricky. Most radiology procedures, unless emergency, normally need pre-approvals in order to receive reimbursement for services rendered. Failure to get a pre-approval can result your medical billing claims for radiology being denied and rejected. Make sure you have a pre-approval on file before the services are rendered. Contact the carrier, note the date and time that you called. Get the first and last name of whomever approves the services. You may very well need this information in the future if your medical billing claim is denied. There are also CPT coding changes that happen often in the field of

By: Melissa C. - OMG, LLC. CEO on August 25, 2005

Electronic Claims Processing

Electronic Claims Processing One of the reasons that outsourcing your medical billing is so efficient, is because most medical billing firms use electronic claims submissions (ECS). Studies show that only about 40% of medical billing claims are electronically processed when submitted directly by the physician’s offices. In 2003 over 6 billion insurance claims were filed, of that number, around 500 million were Medicare claims. Medicare pays two weeks faster if claims are filed electronically. They offer up this incentive to entice that other 60% of practices that are still filing claims manually with a CMS 1500 form to submit those claims electronically. Another sobering reason to have your claims processed

By: Melissa C. - OMG, LLC. CEO on August 25, 2005

Are Your Medical Billing Claims Being Denied?

Are Your Medical Billing Claims Being Denied? If you’re a physician and your medical claims are being denied, are you getting reasons why or are you simply eating the charges as a consequence of doing business? In the realm of things, some claims will be denied legitimately, but far fewer medical billing claims than you think will be denied in this manner if you outsource your billing. If you are still doing your own coding and billing, this is the number one reason for claims being denied by the carrier. Most practices are too busy to keep up with the coding changes that can happen many times in one year.

By: Melissa C. - OMG, LLC. CEO on August 25, 2005