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In Billing
Sep 1st, 2023
Ensure optimal reimbursement for items that are not billed as durable medical equipment. Assigning the proper codes to supplies, implants, and devices can have a direct effect on coding compliance, charging accuracy, and the amount of outpatient reimbursement that a hospital or facility receives. Healthcare providers routinely use many items that should not be separately ...
Medical coders, billers, and auditors have the expertise to weigh in. This article discusses forensic work with respect to healthcare usual, customary, and reasonable (UCR) fee ranges. This is a peer review article in which the author (me) requests my peers (you) to provide your objective thoughts on the information provided within. The Work of ...
In Billing
Sep 1st, 2023
Know when to bill for debridement separately from surgery. Debridement removes foreign material and/or devitalized or contaminated tissue until healthy tissue is exposed. It essentially cleans up the area and is often performed with other orthopedic surgical procedures. As an auditor who specializes in orthopedics, I frequently see providers bill for debridement in addition to ...
In Billing
Sep 1st, 2023
Know the rules for CLIA waived tests to ensure proper claims payment. Modifier QW indicates a Clinical Laboratory Improvement Amendment (CLIA) waived test performed by a lab with a CLIA certificate. Appending modifier QW to a code indicates that the test was performed at a waived complexity level. Let’s make sure you understand what a ...
In Billing
Aug 28th, 2023
For the 2023-2024 influenza season, which runs from Aug. 1 through July 31, the Centers for Disease Control and Prevention (CDC) recommends everyone 6 months of age and older receive a flu vaccine “ideally by the end of October.” This advice has not changed from previous years, but the Medicare Part B payment allowances for ...