medical billing services

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Ostomy Documentation Tips

https://www.medicalbillersandcoders.com

Medical records must contain adequate, clear documentation that supports the medical necessity of the amount ordered and billed. The quantity of ostomy supplies needed by a beneficiary is determined primarily by the type of ostomy, its location, its construction, and the condition of the skin surface surrounding the stoma.

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Critical Care Services and Medical Necessity

https://www.medicalbillersandcoders.com

Critical care services encompass both treatments of ‘vital organ failure’ and ‘prevention of further life-threatening deterioration of the patient’s condition.

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Self-Audits – Crucial for Your Medical Practice

https://www.medicalbillersandcoders.com

Auditing is important to evaluate the physician processes to make sure their compliance plan is operating correctly and to identify any inappropriate documentation, coding, and/or billing practices.

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POP for Simplifying Documentation Requirements

https://www.medicalbillersandcoders.com

Through ‘Patients over Paperwork,’ CMS established an internal process to evaluate and streamline regulations with a goal to reduce unnecessary burden, to increase efficiencies, and to improve the beneficiary experience.

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Modifier 50 Fact Sheet

https://www.medicalbillersandcoders.com

Bilateral procedures should be reported as a single unit on two separate lines or a single unit with “2” in the unit field on one line, in order for both procedures to be paid correctly. The multiple procedure reduction of 50 percent will apply to all bilateral procedures subject to multiple procedures discounting.

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Moderate (Conscious) Sedation Coding Guidelines

https://www.medicalbillersandcoders.com

Moderate sedation are services provided by the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports. They require the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status.

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Medical Billing for Therapeutic Shoes for Individuals with Diabetes

https://www.medicalbillersandcoders.com

Therapeutic shoes for diabetics are not DME and are not considered DME nor orthotics, but a separate category of coverage under Medicare Part B.

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Importance of Medical Audit

https://www.medicalbillersandcoders.com

The medical audit is the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patient.

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1

Changes in RT and LT Modifier Usage

https://www.medicalbillersandcoders.com

Several DME MAC LCD-related Policy Articles require the use of the RT and LT modifiers for certain HCPCS codes.

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Basic Guidelines for Inhalation Treatment Billing

https://www.medicalbillersandcoders.com

There are many services and products that may be billed when a patient presents with chronic asthma or other serious respiratory conditions or acute exacerbation of related symptoms. 

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