Jun 18, 2010 | Medical billing basics
Diagnosis codes must be reported based on the date of service (including, when applicable, the date of discharge) on the claim and not the date the claim is prepared or received. Medicare contractors are required to be able to edit claims on this basis, including...
Jun 16, 2010 | Medical billing basics
Incidental findings should never be listed as primary diagnoses. If reported, incidental findings may be reported as secondary diagnoses by the physician interpreting the diagnostic test. EXAMPLE 1: A patient is referred to a radiologist for an abdominal ultrasound...
Jun 16, 2010 | Medical billing basics
Determining the Appropriate Primary ICD-9-CM Diagnosis Code for Diagnostic Tests Ordered Due to Signs and/or Symptoms A. Confirmed Diagnosis Based on Results of Test If the physician has confirmed a diagnosis based on the results of the diagnostic test, the physician...
Jun 16, 2010 | Medical billing basics
Proper coding is necessary on Medicare claims because codes are generally used to assist in determining coverage and payment amounts. The CMS accepts only ICD-9-CM diagnostic and procedural codes that use definitions contained in DHHS Publication No. (PHS) 89-1260 or...
Jun 10, 2010 | Medical billing basics
The prothrombin time (PT) test is an in-vitro test to assess coagulation. PT testing and its normalized correlate, the International Normalized Ratio (INR), are the standard measurements for therapeutic effectiveness of warfarin therapy. Warfarin, Coumadin®, and...
