Nov 17, 2009 | Medical billing basics
Medicare Part B Covered CPT codes Generally we cant say which CPT codes are covered or not. If differs from each state and it has to be determined by local Medicare but we can give by which type of services are covered or not. Medicare Part B helps pay medically...
Nov 16, 2009 | Medical billing basics
D1 Claim/service denied. Level of subluxation is missing or inadequate. D2 Claim lacks the name, strength, and dosage of the drug furnished. D3 Claim/service denied because information to indicate if the patient owns the equipment that requires the part or supply was...
Nov 15, 2009 | Medical billing basics
PR-B8 Alternative services were available, and should have been utilized. Common Reasons for Message Medical documentation is lacking medical necessity Next Step Verify medical documentation for the following: ...
Nov 14, 2009 | Medical billing basics
Glossary ADA – American Dental Association: A professional association of dentists committed to the public’s oral health, ethics, science and professional advancement. http://www.ada.org AMA – American Medical Association: The American Medical Association helps...
Nov 10, 2009 | Medical billing basics
Modifiers and their Role in Billing Modifiers are used to modify payment of a procedure code, assist in determining appropriate coverage, or otherwise identify the detail on the claim. The use of modifiers ensures the appropriate reimbursement by the insurer....
Nov 10, 2009 | Medical billing basics
Guidelines to Improve Reimbursement The organizational flow of information and accurate documentation and coding is crucial to processing third party claims. To prevent claims from being rejected, the business process needs to review such areas as: •...
Nov 9, 2009 | Medical billing basics
General Billing Guidelines • All fee schedules need to be reviewed and updated yearly. The Custom Fee Analyzer can be purchased and used as a guide for reviewing the outpatient fee schedule for the facility. The Analyzer begins with a detailed process on how to review...
Nov 7, 2009 | Medical billing basics
CPT Modifier 59 – Distinct Procedural Service Instructions Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-evaluation and management (E/M) services performed on the same...
Nov 7, 2009 | Medical billing basics
Modifiers 26 and TC Recently Palmetto GBA has noticed a number of diagnostic services being filed on the same day by different providers. In some of these instances one provider has filed for either the professional or the technical component while the other provider...
Nov 7, 2009 | Medical billing basics
Modifier 52 for Reduced Serv ices Under certain circumstances a service or procedure is partially reduced or eliminated at the physician ’ s direction. Under these circumstances, the service provided can be identified by its usual procedure number and the addition of...
