Billable services

coder911

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Hello all,
I have been coding for 3.5 years now - I've had the opportunity to code several specialties (I was working for a billing company) and have spent this past year with a Family Practice group of 9 providers. There are quite a few facets to this specialty, and I keep running into billable services that this clinic hadn't used or considered before. For example, I've asked the docs to dicatate on the issue of smoking cessation when it is applicable (not always paid on :( ) - and I recently started a project for reviewing and billing CPO services over the past 1.5 years (which is actually starting to yield results :D ).
I'm just wondering if there might be some coders out there that know of, or have stumbled over, other services like these that might've "slipped" through the cracks? Anything to watch out for other than your typical E/M or minor Sx?
Thank you
 
Last edited:

anleocpc

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Family Practice

Hi, do not forget about the home health reimbursements G1080 and G1079, these are payable by Medicare. And I agree smoking cessation codes are a very lucrative and viable source of revenue.

Anne Leo, CPC :)
 

coder911

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Thx

Great, thank you!
Sometimes we find big things, sometimes they're small - but everything definitely helps. I'll check those codes out ;)
 
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San Diego
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Hi, When I did auditing of charges for a billing company I found errors that led to incorrect reimbursement, for example: not billing the appropriate units of medication (J codes), not billing for "each" immunization admin or not billing it at all in some cases, billing of 17003 w/out 17000, not billing for
G0101 & Q0091 to Mcare, charges going out with $0.00 in the fee column (!), billing services with incompatable dx's (refer to LCD's/LMRP's), not using the QB modifier when appropriate. By taking a look at certain codes and making sure they were being billed correctly, we were able to increase revenue while also making sure things were coded properly. Hope this helps!
 

Leenahz

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Bedford, VA
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Hi coder,

I was in family practice coding and billing for 10+ years. I found codes 99000 and 36415 not being recorded properly at one location. Reviewing laceration repair notes also helped a little as the code selected rarely ever matched the size and complexity of laceration that was documented in the notes. Lastly, check out the Medicare 2015 covered preventative worksheet CMS has out. There's an entire list of 100% covered services.

Lena
 
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