Nov 6, 2009 | Medical billing basics
Modifier 22 The 22 modifier is used to identify an unusual procedural service. By using this modifier you are indicating that the procedure in question required a level of care greater than that usually required. When using this modifier medical records must be...
Nov 6, 2009 | Medical billing basics
Assistant at Surgery (CPT Modifiers 80 81 82 and AS) We will continue to pay assistants at surgery at 16 percent of the surgical allowance, with the exception of Physician Assistants (PA) and Nurse Practitioners (NP), which are further reduced because these...
Nov 6, 2009 | Medical billing basics
a. General Requirements When Medicare is the secondary payer, the claim must first be submitted to the primary insurer. The primary insurer must process the claim in accordance with the coverage provisions of its contract. If, after processing the claim, the primary...
Nov 6, 2009 | Medical billing basics
Medicare implementing new way to submitting Medical records electronically. Check your local Medicare for more information. Changes in Submitting Medical Documentation for Electronic Claims. Effective November 2, 2009, providers will be able to fax medical...
Nov 5, 2009 | Medical billing basics
I Submitted an EDI Enrollment Form. When Can I Start Billing Electronically? Here are some important tips to keep in mind once you have submitted an EDI enrollment form: If you provide an e-mail address of your contact person on the EDI enrollment forms, Medicare EDI...
Nov 4, 2009 | Medical billing basics
We have listed the some common guidelines for printing CMS 1500. Do’s and Dont’s 1) Use original claim forms 2) Use block ink (not a black marker) 3) Print claim data within defined boxes on the claim form 4) Use all capital letters 5) Use a laser printer...
Nov 3, 2009 | Medical billing basics
What is EDI Here i have listed most and common errors in the EDI form when you filled up. So please have this remembered and fill up the form accordingly. Electronic Data Interchange (EDI) Providers can decrease paperwork and increase operating efficiency with...
Nov 2, 2009 | Medical billing basics
101 Predetermination: anticipated payment upon completion of services or claim adjudication. 102 Major Medical adjustment. (Not Medicare). 103 Provider promotional discount (i.e. Senior citizen discount). (Not...
Nov 2, 2009 | Medical billing basics
Medicare denial CO codes 51 These are non covered services because this is a pre-existing condition. 52 The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform/the service billed....
Nov 2, 2009 | Medical billing basics
Medicare denial CO codes 1 Deductible Amount. 2 Coinsurance Amount. 3 Co-Payment Amount. 4 The procedure code is inconsistent with the modifier used, or a required modifier is missing....
