Inpatient Consult Codes | How to Bill for Medicare Billing for Inpatient Consult Admitted Patient in the Hospital
Mar17

Inpatient Consult Codes | How to Bill for Medicare Billing for Inpatient Consult Admitted Patient in the Hospital

Inpatient Consult Codes – How to Bill for Medicare Billing for Inpatient Consult Admitted Patient in the Hospital Codes Your choice of code are based on the 3 Key Components of the Evaluation and Management E/M Services which are the: 1. History, 2. Examination, and 3. Medical decision-making. When billing initial hospital care, all three key… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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Insurance Payment Paid and Allowed 100% of Charged Amount – don’t celebrate! Let me tell you why!
Mar12

Insurance Payment Paid and Allowed 100% of Charged Amount – don’t celebrate! Let me tell you why!

I asked some of my readers about how they will feel if their claims has an allowed amount that is at 100% of the charged amount, wow! So, meaning, when you bill for $2000.00 and the insurance made their determination at 100% of your charges… you bill $2,000, they allowed $2,000 – would you be happy?… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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Can I use modifier 59 for CPT 99204, 99213, 99214, 99215, 99205, 99203 Problem Focused E/M
Mar12

Can I use modifier 59 for CPT 99204, 99213, 99214, 99215, 99205, 99203 Problem Focused E/M

Can I use modifier 59 for CPT 99204, 99213, 99214, 99215, 99205, 99203 Problem Focused E/M   A question from one of my blog readers… By definition, Modifier 59 is used to identify procedures/services that are commonly bundled together but are appropriate to report separately under some circumstances. A health care provider may need to… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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DME Modifiers use for DME Durable Equipment Billing | How to Bill for DME
Mar06

DME Modifiers use for DME Durable Equipment Billing | How to Bill for DME

DME Modifiers use for DME Durable Equipment Billing MODIFIER BP – The beneficiary has been informed of the purchase and rental options and has elected to purchase the item MODIFIER BU The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision MODIFIER KH – DMEPOS item, initial claim, purchase or first month rental MODIFIER KI – DMEPOS item, 2nd or 3rd month rental MODIFIER KX – Requirements specified in the medical policy have been met MODIFIER LL – Lease/rental (use the LL modifier when DME equipment rental is to be applied against the purchase price) MODIFIER NR – New when rented (use the NR modifier when DME which was new at the time of rental is subsequently purchased) MODIFIER NU – New equipment MODIFIER RA – Replacement of a DME, orthotic or prosthetic item MODIFIER RB – Replacement of a part of a DME, orthotic or prosthetic item furnished as part of a repair MODIFIER RR – Rental (use the RR modifier when DME is to be rented) MODIFIER KH – DMEPOS item, initial claim, purchase or first month rental MODIFIER KI – DMEPOS item, 2nd or 3rd month rental KR – Rental item, billing for partial month KX – Requirements specified in the medical policy have been met LL – Lease/rental (use the LL modifier when DME equipment rental is to be applied against the purchase price) MS – Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty NR New when rented (use the NR modifier when DME which was new at the time of rental is subsequently purchased) NU – New equipment QJ – Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 CFR 411.4(B) MODIFIER RA – Replacement of a DME, orthotic or prosthetic item RB – Replacement of a part of a DME, orthotic or prosthetic item furnished as part of a repair RR – Rental (use the RR modifier when DME is to be rented) UE – Used durable medical equipment Searched Keywords: how to bill l3908, how to bill dme modifier, modifier dme, dme biller, dme billing, dme pos, l3908 modifier, l3908 medicare coverage, l3908 wrist brace, l3908 medicare reimbursement, l3908 cost, l3908 fee schedule, l3908 lcd, l3908 reimbursement, durable medical equipment billing codes, dme billing training, dme billing companies, free dme billing training, durable medical equipment billing guide, dme billing jobs, what is durable medical equipment, durable medical equipment companies...

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2017 New CPT Codes for Billing Coding Presumptive Drug Class Procedures, UDS, Urinary Drug Screening and Immunoassay | Point of Care UDT
Jan29

2017 New CPT Codes for Billing Coding Presumptive Drug Class Procedures, UDS, Urinary Drug Screening and Immunoassay | Point of Care UDT

Wow! we have new codes effective January 1, 2017 for Presumptive Screening Toxicology CPT codes. These will replace both the AMA CPT and Medicare’s HCPCS for presumptive drug testing. The following AMA CPT codes for presumptive urine drug testing are now DELETED and no longer recognized effective January 1st 2017 80300 – Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures (e.g., immunoassay) capable of being read by direct optical observation, including instrumented-assisted when performed (e.g.. Dipsticks, cups, cards, cartridges) per date of service **** ONLY report once, regardless of the number of drug class per date of service 80301 – single drug class methods, by instrumented test systems (e.g. Discrete multichannel chemistry analyzers utilizing immunoassay or 2 enzyme assay), per date of service **** Report ONLY once for a single or multiple procedures performed, regardless of the number of performed, classes or results on any date of service 80302 – Drug screen, presumptive, single drug class from Drug Class List B, by immunoassay (e.g. ELISA) or non-TLC chromatography without mass spectrometry (e.g. GC, HPLC), each procedure **** Report each drug class once per date of service 80303 – Drug screen, any number of drug classes, presumptive, single or multiple drug class method; thin layer chromatography procedure(s) (TLC) (e.g. Acid, neutral, alkaloid plat), per date of service **** Report single or multiple drug procedures, once per day of service 80304 – not otherwise specified presumptive procedure (e.g. TOF, MALDI, LDTD, DESI, DART), each procedure **** Report single or multiple drug screenings, per testing site, per date of service, per each procedure DELETED HCPCS G-Codes for Urine Drug Screening for 2017 G0477 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (eg immunoassay) capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service. G0478 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (eg immunoassay) read by instrument-assisted direct optical observation (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service. G0479 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers (eg, immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when performed, per date of service. Your 2017 Presumptive Urine Drug Testing CPT Codes TAKE NOTE:  CMS will recognize the new 2017 AMA published drug testing CPT codes 80305, 80306 and 80307 as replacement codes for HCPCS codes G0477, G0478 and G0479. CPT codes 80305, 80306 and 80307 will...

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Why Physicians Medical Practice Cannot Make More Money
Jan09

Why Physicians Medical Practice Cannot Make More Money

Here are the 7 Common Reasons that I know make sense why many physicians cannot make more money! 1. Reimbursements are NOT being Maximized due to Poor Medical Coding Knowledge, Skill and Analysis Let me show you some example: a. Bilateral Procedure billed anatomically at only “one side” b. Surgery Converted to Open Procedure (the OP report documents from “Lap” to “Open” was performed) – how will you bill and code for this encounter? You may not know this, you cannot bill for both lap and open (check your CCI Edits!) together. And the guideline says, you have to report “Open” on your claim upon submission. c. Unbundling/bundling services that are billable based on the “Edits” and medical necessity d. No knowledge on how to utilize and use Modifiers e. Too naive that payments processed at 100% of the charged amount (“allowed amount”) is NOT GOOD! – it would’ve allowed more! 2. Out of Network Physician Services Payments can be a Big Challenge! Non-contracted physicians can be very challenging. Especially when they send the payments directly to their member / the patient! Any one experienced this? That’s why it is very important  that you make your patient sign a re-assignment of benefits so you get paid directly by the insurance company! You don’t have to accept assignment. 3. Lack of Effective Collection Techniques and Staff Training a. Copay is always due at the time of service – do many physicians do collect copay upfront? b. How often are patient statements being sent out? c. … there’s a lot more to site! 4. Now, isn’t it Time to Negotiate Fees and Update the Fee Schedule? When was the last time or have you ever thought of renegotiating your contracted fees? Wouldn’t it be time to analyze and review your contracts? Maybe its time to renegotiate your fees. 5. Missing “Revenue-Making” Opportunity for Additional Services in the Practice One good example, they know they can make big profit-margin on medically coded LSO Back Braces. And yet, they hesitate to even look at it. The truth is, it is always based on Medical Necessity! and Real-Time-Accurate Documentation, Period. You have to know your guidelines, policies and limitations. They are all out there, well documented. For instance, as a Physician, you are exempted to the Accreditation Process and Surety Bond – as long as you ONLY provide the LSO braces to your own patients as part of your services. READ HERE http://justmypassion.com/Who-are-Exempted-from-DME-POS-from-Accreditation-and-Surety-Bond-Application.html 6. Low Productivity is also one of the Reasons! a. Physician Services b. Accounts Receivables Collection 7. Too Much Cost Running the Practice a. Staffing b. Technology c. Supplies d. Lease There you...

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