Medical Billing and Coding Services

The non-medical works include taking care of all the documentation, eligibility verification, demographic entry, billing and coding and filing of the medical claims. If a single step is overlooked, the claim will be rejected. Thus, a disorganized revenue cycle management can lead to a stockpile of uncollectible with no proper process to streamline it.

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.

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.

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.

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