But because legislators missed the cutoff by one day, some claims were processed using a lower rate.Although the government appeared poised to take a big bite out of your next Part B payments, you have another month before...
Question: Our hospital billing and medical departments say that diagnoses we add to a claim for reimbursement must have a physician endorsement. We’ve researched our Local Coverage Determination (L26884) from National Government Services, the Ingenix Coding & Payment Guide for...
Tip: Bill for the exact units given per patient.
Question: My neurologist scheduled two patients back-to-back for botulinum type B injections. But he didn’t use all of the Botox and we disposed of it. Do I need to report the...
Watch frequency and provide documentation to rationalize extra pay.
Applying modifier 22 (Increased procedural services) can help increase reimbursement if your neurosurgeon documents a greater-than-usual effort during a surgical service. To ensure your claims’ success, surgeons and coders must also...
Medicare won’t pay 69210 alone, so here’s how to unlock payment.
Impacted cerumen removal is a fairly straightforward procedure, but billing for the procedure is not always so simple.
The problem: Most payers, including Medicare,consider 69210 (Removal impacted cerumen [separate...
Hint: Gathering upfront pay and watching E/Ms make a difference.
Children need physicals to participate in their favorite sports year round, but the demand can grow with warm weather approaching. Ideally, the need for sports physicals should provide the opportunity...
Overlooking these new Interstim and hemorrhoid destruction bundles could mean denial headaches.
Payers like Noridian Part B will cover the female stress urinary incontinence treatment code 0193T, but before you submit a 0193T claim, you’ll have to check with the...
Following 10-year-rule eliminates G0121 rejection.
If you slip up on screening colonoscopy claims’ frequency guidelines and eligibility requirements, Medicare will pay you zilch.
Use this guidance to capture every screening dollar your gastroenterologist deserves.
Home in on Eligibility Requirements for...
Decipher what column 1/column 2 means in this neurosurgery bundle example.
Question: Would you explain what the differences are between mutually exclusive and “column 1/column 2″ edits that come from the Correct Coding Initiative (CCI)?
Florida Subscriber
Answer: Mutually exclusive...
No legislative wrangling can take place until April 12.
Unless Congress steps in soon, you could be facing the 21.2 percent Medicare pay cut that you’ve feared since January.
Despite several Congressional attempts to cobble together another temporary pay fix...
Find out what incident-to requirements you have to meet.
Question: Is there any circumstance in which a group can bill all services and all providers (including other physicians) under just the head doctor? I know we can bill NPP...
Keep this job aid nearby to keep your Hodgkin’s coding in the clear.
Speed your coding for ABVD chemotherapy coding with this handy summary of the codes most likely to appear on your claim.
But remember: Base your final code...
Understand testing process to see how codes work together.
If you don’t know “typing” from “crossmatch,” you’ll have a hard time picking the right code when your lab performs human leukocyte antigen (HLA) testing for transplant patients. Get a clear...
Examine Medicare’s coverage guidelines.
Question: My ob-gyn sees a patient who has breast implants or breast augmentation and orders a mammogram. Should I count the mammography as a screening or a diagnostic test?
Louisiana Subscriber
Answer: Implants and augmentation...
Anesthesia, patient well-being can clue you in to the best modifier choice.
When your urologist ends a procedure early, you know you need to append a modifier to the procedure code, but the challenge is deciding between modifier 52 or...
Test your 2010 consultation coding understanding with these questions and answers.
Consultation coding has every practice on edge this year. Ensure that you’ve got a handle on this complicated coding and billing situation by taking this three-question quiz and then...