Medical Claims and Billing

January 6, 2010

Avoid Rejected Claims

Filed under: Coding Tips — Tags: , , — Coder @ 8:57 am

When your medical billing claims get rejected, one claim can put your staff behind on everything they are supposed to be doing.  The patient’s folder will have to be pulled, the notes will have to be re-read and researched, the claim will have to be compiled again and the coding will need to be double checked again to make sure you are using the latest codings and modifiers for the claim. In some cases the carrier will need to be contacted which is more time lost from servicing your practice and the claim will have to be submitted once again and the will take more time away from your day to day servicing of patients.  (more…)

October 8, 2009

Medical Billing System Review

Filed under: Medical Billing Systems — Tags: , — Coder @ 4:55 pm

Combining history of present illness and review of systems is possible when doing medical billing. Many medical billers think this practice is breaking a rule or impossible. However, documenting an element once to account for HPI and ROS is perfectly legal when done correctly.

The CMS states that physicians absolutely do not need to document an element two times just so the person performing medical billing knows it is meant to be used both for review of systems and history of present illness. It is perfectly acceptable to use an element for both.  (more…)

July 2, 2009

How to Bill: Medial Dislocation

Filed under: Coding Tips, How To Bill — Tags: — Coder @ 11:53 am

A common occurrence in the emergency is the dislocation of various joints. They are sometimes incorrectly handled as breaks but shouldn’t be and you could be setting your practice up for a denial at best and audit at worst if you report these procedures incorrectly on your medical billing.

Even if the reduction of the dislocation fails, the attempt should be reported on not only the medical billing as a procedure but also in the documentation as another procedure will have to be tried to relocate the elbow to its proper placement and you can show the timeline for the necessity of other and more involved treatments. (more…)

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