Nov 2, 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 2, 2009 | Medical billing basics
BIPAP Devices Use OPAS or submit form FH-1A to request continued services for BIPAP devices no sooner than 61 days and no later than 120 days after initiation of therapy. Form FH-1A or an attached physician ’ s note must contain a signed and dated statement declaring...
Oct 30, 2009 | Medical billing basics
I have already write many things about CMS or HCFA 1500 form in many article but still there is lot know about CMS 1500. Hence I decided to write some more article about CMS 1500. Click below link for old articles CMS 1500 billing instruction part 1 CMS 1500 billing...
Oct 30, 2009 | Medical billing basics
DME Policy The DME program covers medically necessary durable medical equipment, prosthetics, orthotics, and disposable medical supplies (DMEPOS); which includes oxygen and related supplies, parenteral and enteral nutrition and medical foods. Durable Medical Equipment...
Oct 28, 2009 | Medical billing basics
Two Surgeons (CPT Modifier 62) For co -surgeons, we will continue the current predominant carrier practice of paying 125 percent of the global fee and dividing the payment equally between the two surgeons. No payment will be made for an assistant at surgery in these...
Oct 28, 2009 | Medical billing basics
If a surgeon performs more than one procedure on the same patient on the same day, we will pay 100 percent of the global fee for the highest value procedure only and 50percent of the global fee for the second, third, fourth, and fifth procedure. Each procedure after...
Oct 28, 2009 | Medical billing basics
Denied EOB The below picture is correct example for denial claims. Whenever the claim is denied or your receive the denial claims, you shoud check the Claim adjustment code or Denial reason code in order to work on the claims. If you see the below EOB the denial...
Oct 27, 2009 | Medical billing basics
Background: Type of Service (TOS) is an indicator that the contractor places on the Form CMS-1500 paper form or electronic format. The indicator is mainly used for data purposes. However, in some instances it affects payment. All HCPCS codes have a corresponding TOS...
Oct 26, 2009 | Medical billing basics
Denial claim is a cliam which is not paid for some reason. Usually EOB itself clearly having the reason for denial which is called as denial codes. We need to find this denial codes and need to take the action accordingly. The commone denial reason are given below. 1....
Oct 26, 2009 | Medical billing basics
Recently Quality Health Plan has changed the claim submission address. See the below message from insurance. Please submit all claims to Quality Health plan Attn : Claims department P O BOX 340749 Tampa FL 336974 – 0749 Please do not submit the claims if already...
