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Tag Archives: Billing

Application of Cryotherapy Billing

Hello All,

I am in search of a CPT (if one exists) that would be suitable to use for the application of a cryotherapy device for the following reasons:

Improve recovery time after intense activity or exercise
Increase energy and metabolism
Decrease inflammation in the body (arthritis and other chronic pain conditions etc.)
Faster recovery post-surgery – combined with physical therapy
Increase range of motion
Relieve tendonitis

The unit being used is made by cryousasolutions

I’ve searched via google and bing trying to find a CPT…I myself am leaning towards 97010 as the only option but upper management believes that there may be another applicable code so that we may receive reimbursement. We are not a DME vendor (so no HCPCS).

I think the cryotherapy devices for PT services, unfortunately, fall under the cold pack therapy which most insurance carriers will not pay.

Any feedback will be helpful.

Thanks!

Medical Billing and Coding Forum – Chiropractic

What Are The Best Medical Billing and Coding Programs Online?

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Medical coding and billing is one of the few well-paid, in-demand healthcare jobs requiring solely a post-secondary certificate or associate degree at most. Good Financial Cents listed medical coder as the 20th “Best Job without a College Degree,” providing an average certified salary of $ 46,800. Online education is ideal for this digital IT profession that’s focused on the accurate organization of electronic health records. Online courses can train medical coding and billing staff to translate patients’ diagnoses and procedures into alphanumeric codes to file health insurance claims. As the health informatics field expands faster-than-average by 15 percent, the availability of online medical coding and billing options is becoming staggering. In this article, we’ll help point you to six of the best online colleges for tomorrow’s medical IT staff.

Herzing University

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Headquartered in Menomonee Falls, Wisconsin, Herzing University is a private, nonprofit HLC-accredited training institute that’s seen enrollment skyrocket by 260 percent since 2001. The U.S. News recognized Herzing for delivering America’s 142nd best online undergrad programs for $ 550 per credit hour. Adhering to the CAHIIM Academic Competencies, Herzing offers a 44-credit Diploma in Insurance Billing and Coding Specialist online over 12 months. Online courses like diagnosis coding and pathophysiology lead to a four-credit internship or research project and CCSA certification. Herzing undergraduates could also pursue the 61-credit A.A.S. Insurance Billing and Coding or 124-credit B.S. in Health Information Management.

Learn more about the Medical Billing and Coding Programs Online at Herzing University here.

Indiana University

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Endowed for $ 1.57 billion, Indiana University is a public, nine-campus teaching system in the APLU that’s regionally accredited to educate around 89,170 undergrad Hoosiers total. Graded America’s 27th “Top Public University” on Niche, IU offers the 54th best online undergraduate programs according to the U.S. News. The School of Informatics and Computing places CCA certification in reach for online learners with the 32-week Medical Coding Certificate. Full- or part-time students join each Fall to audit inpatient and outpatient health records. After the culminating, four-credit coding practicum, students can advance into the B.S. in Informatics – HealthCare Information Technology.

Learn more about the Medical Billing and Coding Programs Online at Indiana University here.

Keiser University

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Called the Keiser Institute of Technology until 1986, Keiser University is a private, nonprofit and nonsectarian SACS-accredited institution in Fort Lauderdale that’s educating nearly 18,000 Seahawks at an average net price of $ 21,129. Deemed America’s 30th “Best Online College” on Niche, Keiser is ranked the South’s 11th top value by the U.S. News. Distance learners could obtain the A.S. in Medical Administrative Billing & Coding, which meets CAHIIM standards. Conducted in English or Español, the 60-credit program features online courses from CPT-4 coding to medical ethics before an externship. Coders also have 100 percent job placement after the A.S. in Health Information Management.

Learn more about the Medical Billing and Coding Programs Online at Keiser University here.

Hunter College

 

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As a public, co-educational CUNY constituent, Hunter College is located on Manhattan’s Upper East Side near Lenox Hill to educate over 15,500 undergrad Hawks on a $ 99 million endowment. Ranked America’s 86th “Most Liberal College” on Niche, Hunter is the North’s 11th top public university according to the U.S. News. For $ 4,300 total, students can pursue the five-course Medical Coding & Billing Certificate in 80 hours online. Hunter also as a Combined Certificate in Outpatient and Inpatient Medical Billing for $ 5,300. Students progress through online modules like medical terminology and ICD-10 coding for CPC credentialing with exam discounts.

Learn more about Medical Billing and Coding Programs at Hunter College here.

St. Petersburg College

 

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Holding SACS and CAHIIM accreditation, St. Petersburg College is a public, four-year member of the Florida College System founded in 1927 that’s serving around 65,000 undergrads from Seminole to Clearwater and online. Crowned America’s 105th “Best Online College” on Niche, SPC ranked among Community College Week’s top 100 associate degree producers. Online learners could prepare for the CCA exam by completing the 37-credit Medical Coder Certificate and its two professional practica. Credits transfer seamlessly into the 70-credit Online Health Information Technology A.S. program, which has a 100 percent RHIT pass rate. There’s even a Health Data Management Advanced Technical Certificate.

Learn more about Medical Billing and Coding Programs at St. Petersburg College here.

Pace University

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Attracting around 12,700 Setters from all 50 states, Pace University is a private, nonsectarian ECAC institution tracing back to 1906 that’s located in Lower Manhattan with extensions in Pleasantville and online. Chosen as America’s 51st “Most Diverse College” on Niche, Pace is recognized by the U.S. News for the 36th best online undergrad offerings. Online students develop their e-portfolio with the asynchronous, nine-month Medical Billing & Coding Certificate program. Registering for the $ 3,995 program allows high school graduates to qualify for five certifications, including CCS and CPC-P. For taking the CEHRS exam, choose Pace’s seven-month Online Electronic Medical Records Specialist Certificate.
Learn more about Medical Billing and Coding Programs at Pace University here.

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Separating the good online medical coding and billing programs from the bad isn’t too difficult. Make certain you place accreditation, whether regional or national, at the top of your list to avoid registering at unaccredited diploma mills. Other important factors to search for are CPC certification rates, job placement, financial aid, awards or rankings, online technology, and curricular flexibility. Some honorable mentions to our above list include St. Catherine University, Drexel University, Central Texas College, Kaplan University, and Trident Technical College. The AAPC also offers online medical coding courses that cost members just $ 2,195 total for mastering ICD-10 classification.

Related Links

The 20 Best Medical Coding and Billing Programs Online

Top Medical Coding Schools

Radiation Oncology coding and billing

Hello! I am new to radiation oncology coding and billing. Does anyone have any resources, cheat sheets or tips they would be willing to share with me? Anything would be greatly appreciated! I am tasked with coding radiation therapy, charge entry and working back end denials that have been sitting for awhile.

Also, my employer is looking to send me to a workshop or seminar. Does anyone know of any on the east coast after October 1st?

Medical Billing and Coding Forum – Billing/Reimbursement

Bolster billing compliance: Implement a Medicare Part A triple-check process

Bolster billing compliance: Implement a Medicare Part A triple-check process

Medicare billing is a domain rife with payer offshoots and evolving regulations that can be difficult to navigate without a strategy to weather claim scrutiny and withstand the gaze of CMS’ various auditing contractors.

Enter the triple-check process, a time-tested internal auditing strategy used by proactive long-term care providers to facilitate billing accuracy and compliance the first time a UB-04 claim form is submitted. As its name suggests, triple check is a layered verification process that involves staff members from billing, nursing, and therapy departments?the three core disciplines required to submit a clean claim. But this sturdy foundation is also pliable, allowing a facility to easily adapt the procedure to the various types of claims it files.

Read on for an expert iteration of the triple-check process, which is modified from the HCPro book The Medicare Billing Manual for Long-Term Care, written by Frosini Rubertino, RN, BSN, C-NE, CDONA/LTC. This specific triple-check procedure is designed to mobilize key staff to ensure accuracy and timely submission of Part A claims.

 

Procedure

Each month, the SNF will collect all Medicare Part A billing information ready for submission and enlist the following individuals to carry out their designated roles in verifying the accuracy of these items: administrator, director of nursing, MDS coordinator, facility rehab director or designee, business office manager, medical records personnel, and central supply staff.

The following is a breakdown of each of these staff members’ responsibilities in the triple-check process:

Business office manager and medical records personnel

  • Verify that the qualifying stay information recorded on the UB-04 aligns with that on the medical records face sheet.

 

Business office manager

  • Verify that each resident has benefit days available in the HIPAA Eligibility Transaction System.
  • Verify the admit date on the UB-04 aligns with the date in the manual census log.
  • Verify covered service dates listed on the UB-04 align with those in the Medicare and manual census logs.
  • Verify that a resident’s financial file contains a signed and completed Medicare Secondary Payer form whenever applicable.

 

Business office manager and MDS coordinator

  • Verify that ADLs are correct and are supported by documentation. Confirm that staff have coded all other contributory items (e.g., mood, IVs).
  • Verify that ARDs on each MDS align with the occurrence dates found at form locators (FL) 31?34 on the UB-04.
  • Verify that the RUG level listed on each MDS aligns with that found at FL 44 on the UB-04.
  • Verify that the assessment type for each MDS aligns with the modifier found at FL 44 on the UB-04.
  • Verify that the number of accommodation units listed on the UB-04 aligns with the assessment type for each MDS. Verify that the total number of accommodation units aligns with corresponding covered service dates.

 

Facility rehab director, MDS coordinator, and business office manager

  • Verify that physical therapy minutes listed on the daily treatment grid align with those noted in the service log. Align the days and minutes documented in the MDS with those on the treatment grid. Align the number of units billed on the UB-04 with those in the service log.
  • Verify that each principal diagnosis is accurate, that all secondary diagnoses support skilled care, and that every ICD-9 code corresponds to an appropriate diagnosis.
  • Verify that occupational therapy minutes recorded on the daily treatment grid align with those in the service log. Align the days and minutes in the MDS with those on the treatment grid. Align the number of units billed on the UB-04 with those in the service log.
  • Verify that speech therapy minutes listed on the daily treatment grid align with those noted in the service log. Align the days and minutes in the MDS with those on the treatment grid. Align the number of units billed on the UB-04 with those in the service log.

 

DON and medical records personnel

  • Verify each resident’s need for Medicare skilled intervention by reviewing supporting clinical documentation that corresponds with the dates of service listed in the manual census log.
  • Verify that each (re)certification form has been completed and signed by the appropriate physician.
  • Verify that each physician order has been obtained and implemented.
  • Verify that each chart reflects appropriate charting guidelines. Confirm that charting has been completed at least once in every 24-hour period, relates to skilled service provided, and supports therapy.

 

Facility rehab director

  • Verify that physician orders include rehabilitation.
  • Verify that each evaluation notes the prior level of function.
  • Verify that clinical documentation contains a progress note establishing the need for continued skilled intervention.

 

Administrator

  • Chair the triple-check meeting (detailed below), and ensure that the entire process is completed by appropriate staff each month before Medicare claims are submitted. Participation in the triple check will allow the administrator to monitor the effectiveness of key operational processes carried out by the facility’s ­interdisciplinary team (IDT) on an ongoing basis.

Triple-check meeting and audit tool

Each of the SNF’s triple-check participants should complete their respective duties prior to the Medicare triple-check meeting, which will be held monthly before the SNF bills for a given batch of services. In other words, the meeting is not an occasion for staff to complete their initial claim component(s). Instead, it’s a chance for IDT members to cross-check the work of their colleagues by verifying the accuracy of claim items that others have completed, thereby ensuring each element has been studied by multiple sets of eyes.

The triple-check meeting will also serve as the platform for the SNF’s business office manager to document the completion of each integral item on a billing claim using the triple-check audit tool, an internal checklist-type document that will be included in every month-end closing report.

Using this audit tool, the manager will denote items verified as correct during the triple-check meeting with an "X." He or she will mark items identified as incorrect with an "O" and, in the remarks section of the document, record the steps the team will take to obtain the correct information. Items initially found to be incorrect but rectified during the meeting should still be marked with an "O" to better track any practice patterns that could lead to billing slipups and inform future training activities.

The business office manager will call for any claim found to have errors during the triple-check meeting to be put on hold until it is amended. Once staff have made necessary revisions, the manager will indicate these correction(s) and the corresponding date(s) in the remarks section of the audit tool. He or she will then contact a corporate entity to review the changes and ultimately grant approval to submit the claim.

HCPro.com – Billing Alert for Long-Term Care

Are Your Medical Billing Mistakes Costing Your Patients?

The low estimate on medical billing errors is $ 17 billion, according to a report from the Institute of Medicine. Even if the $ 29 billion they state as the top of the range is an overstatement, do you have your share of $ 17 billion to give back to patients and insurance companies? Furthermore, do you even want a part of the 250,000 patients who die each year because of medical errors (according to the medical journal BMJ) on your conscience?


Improving Medical Billing for Practices

7 Benefits of Outsourcing Your Medical Billing with ICD-10

It can be difficult deciding whether to outsource your medical billing or not. With ICD-10 coming in October, There are many benefits of outsourcing your revenue cycle functions. Let’s take a look at 7 of those benefits.

 
#1 Economy of Scale
A billing service will distribute their expenses through their complete client base, which provide an economy of scale. They are able to operate with lowers costs than what a single practice can and those savings are passed on to their clients, making them very competitive. A billing service is able to afford to hire top-notch staff so you are able to pay less and get more.

 

#2 Highly Trained Dedicated Specialists
The outsourcing team has just one purpose – its focus is to increase your practice’s profitability. They will review and post payments from the carriers to ensure that you are getting the correct amount and preventing adjustments that are incorrect. Every claim that’s outstanding will be tracked until it is paid in full. The team that handles all elements of your medical billing is the same staff to ensure cohesion.

 

#3 Gain Control
There’s a mistaken assumption that if you outsource your medical billing you will give up control. In fact, quite the opposite is true. You tend to gain more control. You have a team of dedicate professionals that are taking care of this consuming task. They have the headache of dealing with monthly reports and ensuring that payments are forthcoming in a timely manner and that billing is carried out correctly and with complete transparency.

 

#4 An Industry That’s Changing
The landscape of healthcare itself is rapidly changing and medical billing has been dragged into the middle of this upheaval. Keeping up with all the changes in the requirements and rules can be difficult. It requires continuous learning. The delete and added CPT codes come out years. Carrier rules and fee changes occur almost daily. Most people simply do not have the necessary time to dedicate to this continuous learning curve. Outsourcing to a team of professionals is very helpful.

 

#5 Get Paid Faster
Cash flow is the key to your successful practice. Accounts receivable collections have a significant impact on your revenue and your bottom line. This is where outsourcing your medical billing can be beneficial allowing for claims to be submitted faster and with fewer errors. That means you’ll receive your payments in shorter period of time. By outsourcing, you have a team of professionals that all billing to be carried out in a timely manner, and the turnaround time can be significantly reduced.

 

#6 Focus on What You do Best
You spent so many years going to university to become a doctor so that you can help people. The little free time you have, you probably hate spending on the intricacy of medical billing or maybe you hate having people on staff that cost you a fortune. A better option is outsourcing, where you get a team of professionals at a much lower cost than having your own staff.

 

#7 Reduced Stress and Increased Cash
A top-notch billing service will charge a percentage for collecting the money but compared to having to run your own billing office and staff it the fee is really quite nominal. You are suddenly getting the highest rate of return from your carriers, which means that you have more disposable income. Almost all practices that outsource their medical billing see an increase in their revenue and a decrease in their billing costs.

 

ICD-10 is complicated and the number of codes is rising from 13,000 to 68,000. That’s huge! This is going to lead to a significant increase in the number of payer denials and it is expected that there will be a decrease in cycle time. Outsourcing is a great way to save you time and money learning all of the new ICD-10 codes leaving it to a team of well trained professionals.

The post 7 Benefits of Outsourcing Your Medical Billing with ICD-10 appeared first on Outsource Management Group, LLC..

Outsourcing – Outsource Management Group, LLC.

Is It Time to Outsource Your Medical Billing?

If you are noticing your medical billing claims are taking longer and longer to be reimbursed or you are having denials, rejections, or only partial reimbursements on your medical billing claims, it may be time to look at outsourcing your medical billing claims. You may feel as though you would be giving up control of your cash flow when actually you will have more control than ever. In fact, outsourcing your medical billing and coding needs through a medical billing partner is one of the smartest business moves you can make.

The best company to handle your medical billing isn’t necessarily located around the corner from your practice or even in the same town. Thanks to the power of the Internet, secure Internet connections, and advances in software and computer networks that allow for secure transmission of sensitive data, the process of finding a medical billing company to handle your needs is just a mouse click away.

This will free up your staff immensely as they will no longer have to spend long hours at the copy machine getting claims ready to send in. Your claims will be transmitted computer to computer via secure network transmissions and you can get real-time information on your patient accounts at anytime. Furthermore, outsourcing your medical billing will insure that all your claims are properly coded and documented properly. Your medical billing partner can devote 100% of their time to handling your coding and claims. That way your cash flow is steady and you can concentrate on growing your practice.

The post Is It Time to Outsource Your Medical Billing? appeared first on Outsource Management Group, LLC..

Outsourcing – Outsource Management Group, LLC.

Hydration Billing Question

I have a hydration billing question that I just can’t seem to find definitive guidance on….

Lets say we have a patient that’s comes in and the records reads along these lines:

Saline 1000MG 0900am-125

Other drug (any kind of chemo) 0932-1032

other drug (A therapeutic drug) 1033-1245

Here is how I have been billing: Other drug (chemo) 0932-1032=60 min =96413
Other drug (therapeutic) 1033-1245=2.12 =96367 and 96366
Hydration= 09-932=.31 + 1245-125+.40 = 1.11 =96361

Is this correct or would each chunk of hydration stand on it’s own making the correct billing 96361X2???

Please Help!

Medical Billing and Coding Forum – Hematology/Oncology