Sunday, November 12, 2006
Getting the Sequence Right for Medical Billing
You know when you're translating medical billing from the notes, that sometimes doctors get a little bit out of sequence. This can greatly affect your medical billing if you don't straighten it out before filing. Otherwise you can wind up only receiving partial reimbursement for procedures done or worse, an outright rejection of your claim from the carrier.
One of the easiest ways to make sure you get the sequencing right is to read the entire report and make yourself notations on the major procedures done to be sure that you are picking up a good flow of information all the way through.
Get the doctor's summary of the diagnosis and then outline the services performed and allot them by code so your medical billing will flow logically. If you see any modifiers that should be added make a note of them as you go through so you don't overlook a small modifier later that can make or break your medical billing claim.
Check for NCCI edits. This will keep you from doubling up on any services already covered and again will make your medical billing claim flow in a logical manner. If you find there were extra services performed during the procedure, you can use modifier 22 and bundle your codes. This is especially helpful for Medicare claims. Using modifier 22 puts the medical billing claim under manual review and insures the carrier will review the bundled coding and see that all services were necessary for that procedure. This will help get you full reimbursement on special situations that otherwise may have been denied or partially reimbursed since they were bundled medical billing claims.
One of the easiest ways to make sure you get the sequencing right is to read the entire report and make yourself notations on the major procedures done to be sure that you are picking up a good flow of information all the way through.
Get the doctor's summary of the diagnosis and then outline the services performed and allot them by code so your medical billing will flow logically. If you see any modifiers that should be added make a note of them as you go through so you don't overlook a small modifier later that can make or break your medical billing claim.
Check for NCCI edits. This will keep you from doubling up on any services already covered and again will make your medical billing claim flow in a logical manner. If you find there were extra services performed during the procedure, you can use modifier 22 and bundle your codes. This is especially helpful for Medicare claims. Using modifier 22 puts the medical billing claim under manual review and insures the carrier will review the bundled coding and see that all services were necessary for that procedure. This will help get you full reimbursement on special situations that otherwise may have been denied or partially reimbursed since they were bundled medical billing claims.
# posted by Medical Information : 2:14 PM
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