This article looks at three ophthalmology medical coding myths that could be causing coding errors and affecting payments.

Be Careful When You Code FBRs

First Myth – All Foreign Body Removals (FBRs) within a single eye are clubbed together, which means an FBR code can only be coded once per eye.

The Actuality – It is true that a coder cannot separately report removal of many foreign bodies from the same region of the eye. However, if the ophthalmologist has removed foreign bodies from different regions of the same eye (such as the conjunctiva and cornea) codes can be separately reported for each region. The ophthalmologist should draw a comprehensive figure of the eye that makes clear the specific region and depth of the removed FBRs. If the ophthalmologist has taken out an embedded conjunctival foreign body, you can report a code in 65210 which offers higher reimbursement. This is good news for both coder and physician.

Second Myth – A foreign body diagnosis can be coded even if the examination doesn’t reveal a foreign body.

The Actuality – It is not correct to report a foreign body ICD-9 code (930.0-930.9, Foreign body on external eye) when a foreign body has not come up in the ophthalmologist’s exam. However, coding can be done for the sensation of a foreign body, with an eye pain code (for example 379.91).

Third Myth – The kind of instrument the ophthalmologist uses establishes which FBR code to report.

The Actuality – The FBR series of codes (65205 to 65222) make no mention of a specific instrument to take out the FB. Nevertheless, CPT® code 65222 (Removal of foreign body, external eye; corneal, with slit lamp) does point out the equipment utilized to make viewing the affected area easier. If the ophthalmologist made use of a slit lamp to see the corneal foreign body, the code to be used is 65222. If he didn’t use a slit lamp, the code is 65220.

Outsource to Minimize Errors

To ensure that your medical coding process is not affected by myths or errors that can even cause claim denials, it is best to outsource this process to experts. Do research to find an HIPAA compliant outsourcing company with a good reputation, a superior track record and an extensive client base.

Medical coding is a job that carries with it a lot of responsibility. Being a physician, you know that the medical coding process involves several duties:

• Completing claim forms
• Signature verification
• Communication with healthcare providers
• Data entry
• Software based analysis of charts or medical data
• Use of correct medical terms to document all activities
• Conforming to the procedures and policies of each insurance carrier
• Bookkeeping
• Administrative work
• Supervision
• Scheduling appointments and more

Benefits of Outsourcing to the Right Medical Coding Company

As such, it is important that when outsourcing, the task can be entrusted only with experts with known efficiency. Some of the benefits of choosing the right medical coding outsourcing service provider:

• Presence of coders with AAPC (American Association of Professional Coders) certification
• ICD-9 coding performed using CMS and AMA guidelines as the basis
• Up-to-date knowledge of procedure changes for bundling and unbundling, payer specific requirements, appropriate coding initiatives and problems associated with federal or state government compliance
• Complete HIPAA compliance
• Medical coding audits
• In-patient or hospital coding
• Fewer denials
• Clean claims

An expert medical coding company provides services in complete compliance with prominent medical insurances such as Oxford, Medicaid, Medicare, Aetna, HIP, EMI, GHI, United, Humana and BCBS.

Medical billing and coding tasks are important procedures that should be done with a great deal of care and attention. Medical billing procedures are now becoming more and more complex with a number of specific government regulations to bear in mind. Hence many healthcare entities and individual practices are increasingly depending on professional companies to carry out the billing and coding procedures with precision. Professional services offered by an experienced medical billing and coding company can help you submit error-free medical bills and insurance claims within the stipulated time frame, improve the revenue and make your practice grow.

Systematic Medical Billing and Coding Services Maximize Cash Flow

Any sort of errors or inconsistencies in medical bills and insurance claims can lead to denials or rejection of claims, which would adversely affect the revenue and overall development of your medical practice. Consistent medical coding and billing strategies and solutions offered by a reliable medical billing and coding company can help you complete the billing and coding procedures punctually and submit accurate medical claims and bills within the specified time limit. Medical bills submitted in keeping with all prescribed norms reduce even the minutest chance of claim denials and would definitely help to improve the bottom line and cash flow of your practice. Systematic medical billing and coding services offered by reputable medical billing companies also ensure the following benefits:

• Save precious time and effort needed to complete the coding and billing procedures
• Concentrate on core competencies
• Reduce workload and improve efficiency
• Avoid paper work within the practice
• Reduce compliance risks
• Avoid capital investment required to maintain additional staff and infrastructure to perform medical coding and billing procedures in-house
• Quality solutions in fast turnaround time
• Customized billing procedures
• 100% compliance to HIPAA norms
• Standard quality assurance procedures
• Technical support and customer care 24/7/365
• Affordable pricing: save around 30 to 40 percent of costs

Fully aware of the billing and coding requirements of healthcare entities, many established healthcare BPO companies in the United States offer accurate medical billing and coding services. Multi-specialty hospitals, imaging centers, rehabilitation clinics, home healthcare agencies, insurance companies, individual physicians, group practitioners, long term care facilities, dental offices, acute care facilities, and nursing clinics are now benefited by these services.

Premium Quality Coding and Billing Solutions

Most medical billing companies are staffed with experienced billing and coding specialists having excellent know-how in ICD-9-CM, CPT and HCPCS codes and standards, payer-specific coding requirements, and insurance and governmental regulatory specifications. Utilizing state-of-the-art technology, equipment and advanced billing software such as Medisoft, Lytec, Medic, NextGen, Medical Manager, Misys, Inception, E-clinical, Eclipse and more they process medical bills and claims with accuracy within the specified time frame. Well-planned medical coding and billing services provided by an established medical billing and coding company include:

• DRG/ICD-9-CM coding validations
• Hospital/in-patient coding
• Emergency room e-code evaluation
• CPT medical coding
• Patient enrollment
• Insurance authorization
• Insurance verification
• Coding and audits
• Account analysis and denial management (EOB Analysis)
• Financial management reporting
• Billing and reconciling of accounts
• Appeals
• AR follow-up and collections management

Find a Reliable Company

Briefly, medical billing services offered by reputable companies are a real support for healthcare facilities and individual practices. However, to get quality billing and coding solutions that would help you enjoy outstanding benefits, it is necessary to partner with an experienced medical billing and coding company. This would ensure you more accurate and budget-friendly solutions that would help your practice grow through completely reducing the odds of claim denials. A good BPO firm would work as an extension of your practice, completing all tasks entrusted in an efficient and timely manner.

To help radiology medical practices reduce their workload, as well as save overhead costs, professional medical coding companies offer quality radiology medical coding services at affordable rates. These services greatly benefit individual radiologists, group practitioners, hospitals, medical centers and clinics.

Reduce Overhead Cost and Maximize Reimbursement

By outsourcing their radiology medical coding tasks to established medical coding companies, individual radiologists and radiology practices can get the work done on time and at affordable rates. Outsourcing the intricate and specialized task of HIPAA medical coding also saves the infrastructure expenses that would be needed to do the work in-house. The other benefits of going in for the radiology coding services that outsourcing companies offer are:

• Submit medical bills and claims without errors
• Reduces the odds of claim denials and rejections
• 100% HIPAA compliant coding services
• Stringent quality control
• Feedbacks on a daily basis
• Real-time document summaries
• Daily, monthly and weekly coding status reports
• Optimum reimbursement
• Coding solutions in customized turnaround time
• Saves time and effort
• Enhances efficiency and productivity
• Allows focus on core capabilities

Experienced Professionals provide Accurate Coding Solutions

Most outsourcing companies that offer radiology coding services are equipped with sophisticated technology and have experienced medical coding specialists on the job. With excellent know-how in HCPCS, ICD-9-CM and CPT codes and standards, insurance and governmental regulatory requirements, as well as payer-specific coding needs, they go all out to deliver accurate coding solutions within the specified period of time. The important services that come under medical coding are:

• DRG/ICD-9-CM coding validations
• Hospital / in-patient coding
• CPT medical coding
• Medical coding audits
• Emergency room e-code evaluation
• ICD-9 coding based on AMA and CMS guidelines
• ASC’s – Ambulatory Surgical Centers Coding

Reliable Provider for your Radiology Coding Needs

While outsourcing their medical coding tasks, radiology medical practices should take care to assign the job to an efficient medical coding service provider that can offer HIPAA compliant services at affordable rates.

The endocrinology system consists of the pituitary gland, the pineal gland, thyroid and parathyroid glands, thymus, adrenal glands, pancreas, ovaries and testes. Medical terms related to the endocrine system are organized on the basis of conditions, diseases, diagnostic procedures and operations. Conditions include those related to the endocrine system glands and hormones, metabolic conditions and nutritional deficiency conditions. Endocrinology medical coding involves assigning the accurate diagnosis and procedure codes. The diagnostic codes are classified under

• Disorders of the thyroid gland (240 -246.9)
• Diseases of other endocrine glands (250 – 259.9)
• Nutritional deficiencies (260 – 269.9)
• Other metabolic disorders and immunity disorders (270 – 279.9)

Operations on the endocrine system are coded as (a) Operations on the thyroid and parathyroid glands (06) – these codes refer to aspiration, incision, excision and biopsy of the parathyroid and thyroid glands. (b) Operations on the other endocrine glands (07). These include incisions, exploration, excisions and biopsies of the pineal gland, pituitary gland, thymus and adrenal glands.

The categories of Nuclear Medicine (92) and Injection or infusion of therapeutic or prophylactic substance (99.1) in the ICD-9-CM listing also mention endocrine glands/hormones.

Endocrinology Diagnostic Tests that Are Coded

An endocrinologist employs diagnostic tests for many reasons. These include:

• To find whether the endocrine glands are working perfectly
• To measure the hormone levels in the patient’s body
• To diagnose the reason for an endocrinology problem/condition
• To confirm some earlier diagnosis

An endocrinologist may order tests such as:

• ACTH stimulation test
• CRH stimulation test
• Bone density test
• 24 hour urine collection test
• Fine needle aspiration biopsy
• Oral glucose tolerance test
• Continuous glucose monitoring (CGM)
• Dexamethasone suppression test
• Semen analysis
• 5 day glucose sensor test for diabetes
• TSH blood test
• Thyroid scan

Treatments Usually Recommended

According to the condition or disease, the endocrinologist offers suitable treatments, which can be billed for reimbursement.

• Insulin pump
• Parathyroid hormone therapy and Biphosphonate therapy for osteoporosis
• Pituitary hormone replacement therapy
• Male hormone replacement therapy
• Thyroid hormone replacement therapy
• Radioactive iodine therapy

Coding for Continuous Glucose Monitoring

Continuous glucose monitoring is an important procedure in endocrinology and is reported using the CPT codes 95250 and 95251.

• 95250 – To report the technical component of CGM; for patient training, monitor calibration, glucose sensor placement, removal of sensor, use of a transmitter, downloading of data.

If the services are provided by a certified diabetic educator or a registered nurse under the supervision of a physician, the supervising physician can claim reimbursement for those services.

• 95251 – To report analysis and interpretation of CGM data. It signifies the professional component and can be billed only by a physician, a nurse practitioner or physician assistant.

Face-to-face visits with the patient can be reported using the appropriate evaluation and management code. The device component for CGM is reported using HCPCS codes. Specifically assigned HCPCS codes help to establish credibility for the medical technology used and thereby reduce claim denials.

Coding for Ultrasound Evaluation

Diagnostic ultrasound and associated ultrasound guided procedures performed by endocrinologists are coded in the following manner:

• CPT 76536 – ultrasound, soft tissues of head and neck (e.g. thyroid, parathyroid, parotid), real time with image documentation
• CPT 76942 – ultrasonic guidance for needle placement (e.g. biopsy, aspiration, localization device, injection), imaging supervision and interpretation
• CPT 10022 – fine needle aspiration; with image guidance
• CPT 60100 – biopsy thyroid, percutaneous core needle

Other Services Covered

• Bone density studies – usually coverage for this service depends on the insurance carrier, and is dependent on the diagnosis codes and frequency of service.
• Diabetes education – this is covered by most insurance carriers, but the CPT code they accept for this type of service often varies. You will have to verify the codes accepted by each carrier to avoid denials.
• Nerve conduction tests – since these are often performed on multiple muscles, they should be billed with multiple units. You should document and bill for all muscles.
• Radionuclide Therapy/Diagnostics – find out if this is reimbursed and how the payer reimburses. Insurance carriers might deny the medicine, considering it inclusive with therapy/tests.

Use of Modifier when Coding for Endocrinology Procedures

Modifiers are used along with CPT codes to report any modification in a certain service or procedure. Services distinct from other non E/M services performed on the same day, but are considered appropriate under the particular circumstances have to be reported using the modifier 59. However, this code has to be supported with relevant documents showing

• A different session
• A different procedure/surgery
• Site  or organ system

Documentation must also support a separate incision/excision, injury/area of injury, lesion. It is to be remembered that modifier 59 can be used only when there is no other established modifier available to report the procedure. This modifier cannot be used with an E/M service.

Modifier 25 is used to report a distinct or separately identifiable E/M procedure along with a non-E/M service performed by the same physician on the same day of the procedure or other service. To ensure reimbursement, the medically necessary E/M service and the procedure have to be sufficiently documented by the physician or qualified NPP in the patient’s medical record. When using modifiers, it is best to contact individual insurance carriers to find out if they have any limitations in reimbursing claims reporting modifiers.

The modifier -52 has to be used to signify that a particular service or procedure was reduced or not done at the doctor’s discretion. So, this code helps to report reduced services without creating confusion as regards the basic service provided.

Any procedure code can be reported using the modifier 26, which signifies the professional component whenever applicable. The technical component is to be reported using the modifier TC. For instance, the physician providing the interpretation of an ultrasound examination can claim for the professional component using the modifier -26 appended to the ultrasound code. Similarly, the owner of the equipment can use the modifier TC signifying the technical component of the service, usually performed in an IDTF (Independent Diagnostic Testing Facility).

How Medical Coding Companies Can Help

Endocrinology coding is a complex procedure, requiring in-depth knowledge regarding the diagnostic and procedure codes. In addition, familiarity with the reimbursement policies of individual payers is vital. You need to be thorough about where the service was provided, by whom it was provided, why it was provided and what service was provided before starting to code for a particular procedure. This can be quite tedious for busy medical practitioners and practices. You might often end up without getting paid for all your services. Moreover, you have to be cautious against fraudulent coding practices such as overcoding, undercoding, jamming, unbundling and upcoding. Your best option is to approach a reliable medical coding company which offers the services of certified coders knowledgeable in CPT, ICD-9-CM, ICD-10 and HCPCS coding practices. With accurate and timely coding and billing services, such a company ensures that you get paid for your services.

With the rising demand for radiology medical coding services, numerous medical coding companies have come forward to assist medical facilities with streamlined solutions. These services are aimed at helping radiologists and medical practices maximize their revenue at reduced overheads.

Core Benefits of Affordable Radiology Transcription Service

Assigning special codes for the different radiology procedures is an extremely a complex and time-consuming task. Outsourcing their radiology coding tasks to experienced companies helps individual radiologists and medical practices to get the coding work done on time and at affordable rates.   Organized radiology coding services ensures radiologists and health care facilities an array of benefits such as:

• Saves the precious time and effort needed to complete the coding tasks
• Maximizes the revenue of the practice
• Reduces  administrative responsibilities
• Reduces the odds of claim denials
• Ensures accuracy in medical bills and claims
• Avoids coding backlogs
• Reduces the overhead costs needed for maintaining  additional coding staffs and infrastructure to perform  in-house coding

Precise Solutions for Your Specific Coding Needs

Medical coding companies offering affordable radiology coding services are staffed with a panel of experienced and talented medical coders and technicians with extensive knowledge on various medical coding rules and procedures. They can efficiently resolve the coding needs of all radiology subspecialties including diagnostic radiology, interventional radiology, ultrasound, MRI and many more. The AAPC- certified medical coders efficiently assign HCPCS, CPT and ICD-9 coding to interventional radiology procedures such as ultrasound and diagnostic radiology imaging, as well as non-interventional radiology procedures including contrast studies, magnetic resonance imaging, computer tomography, standard radiographs and single or multiple views.  Professional radiology coding services come with:

• Basic and advanced level coding solutions
• Stringent quality assurance
• HIPAA compliance
• Real-time document summaries
• 24 hour turnaround time
• Regular feedback
• Daily, monthly and weekly coding status reports
• Affordable rates

Seek the Assistance of an Established Coding Company

To obtain efficient radiology coding solutions to suit the requirements of your medical practice and budget specifications, locate an established medical coding company.  Ensure that you obtain consistent and affordable radiology coding services that significantly minimize your workload, as well as maximize the efficiency and income of your radiology practice.

Most radiology medical practices and individual practitioners in the United States are looking for professional assistance to efficiently manage their diverse coding tasks. Accurate medical coding is very important when it comes to optimizing their collections. If your facility or practice is seeking radiology coding services, it is would be a good idea to look in Oklahoma. An experienced radiology coding company in Oklahoma can offer individual radiologists, group practitioners, hospitals, medical centers and clinics competent coding services at competitive prices.

Accurate Radiology Coding Services

Radiology coding companies in Oklahoma are well-equipped to provide quality radiology medical coding services. They employ certified medical coders proficient in HCPCS, CPT, ICD-9 codes and standards, and  well aware of the latest government norms. They offer accurate coding solutions for interventional radiology procedures including ultrasound and diagnostic radiology imaging, as well as non-interventional procedures such as single or multiple views, standard radiographs, computerized tomography, contrast studies and magnetic resonance imaging.  The core services of a reliable radiology coding company in Oklahoma would cover:

• Emergency room e-code evaluation
• Medical coding audits
• ICD-9 coding based on AMA and CMS guidelines
• ASCs – Ambulatory Surgical Centers Coding
• CPT medical coding
• Backlog coding resolution services
• Hospital/ in-patient coding
• DRG/ICD-9 CM coding validations

Locate an Established Company

Online resources are a great help when it comes to finding an established radiology coding company in Oklahoma.  Searching web directories and the yellow pages with the zip code of the area would provide  a comprehensive list of the companies in the location. Reading blogs, newsletters, articles and reviewing forum discussions are the other important ways of selecting a professional company for your coding needs.

Points to Consider while Choosing a Radiology Coding Company

Before choosing a radiology medical coding company for your medical facility, you would have to evaluate its services. The main points for consideration are:

• Whether its coding procedures strictly adhere to Local Medical Review Policies (LMRP) and Correct Coding Initiatives (CCI)
• Accuracy rates
• Whether the firm offers stringent quality assurance
• Whether its coding procedures are compliant with the HIPAA norms
• Whether it  can offer comprehensive solutions in fast/customized turnaround time
• Pricing structure
• Whether it offers free trial options
• Whether it provide 24/7/ 365  technical assistance

The organized radiology medical coding services of a reputable radiology transcription company in Oklahoma can help you to submit error-free medical bills and claims within the specified time frame.  This would avoid claim denials and help you obtain maximum reimbursements for your practice.

Outsourcing radiology coding services assure an assortment of benefits for radiology departments, individual radiologists, imaging centers and hospitals. The most important benefit is that radiology medical coding outsourcing services offer radiologists more time to concentrate on their core activities. Further, these services help them to competently reorganize their entire coding system, enhance the overall efficiency of their healthcare practice and reduce the workload of their staff for focus on more important tasks.

Multifarious Benefits

Several established medical coding companies in the U.S. offer radiology coding services at competitive prices. Entrusting your radiology coding jobs to these firms allows radiology practices to resolve their regular coding needs efficiently.  Outsourcing radiology coding services ensure the following benefits:

• Reduces administrative responsibilities: Professional coding services significantly reduce the administrative responsibilities and workload of radiologists.

• Saves time and effort:  These services save the precious time and effort that radiologists would otherwise need to complete their coding tasks. This allows them to focus better on providing timely diagnosis and treatment solutions for their patients.

• Reduces possibilities of claim denials: Assigning codes to different radiology procedures needs proper attention and a thorough knowledge of the entire coding system. Even a small error in the codes can lead to claim denials. Efficient coding helps in the submission of error-free medical bills and claims to eliminate the possibilities of claim denials or rejections.

• Ensures maximum reimbursement: Timely submission of accurate medical claims and bills maximizes reimbursements and enhances the revenue prospects of the medical practice.

• Reduces infrastructure overheads: By outsourcing their coding tasks, radiologists and medical facilities can save the expenses needed to maintain additional staff and infrastructure to perform in-house coding.

Excellent Coding Accuracy

To deliver high quality radiology medical coding services, reputable medical coding companies are equipped with skilled AAPC certified coders and technicians with up-to-date knowledge on the coding rules. They ensure customized radiology coding solutions in minimum turnaround time.  Their radiology coding services ensure:

• Completion of coding tasks within the client-specified TAT
• Excellent accuracy rates
• Compliance with HIPAA norms
• Real-time document summaries
• Stringent quality assurance at three levels
• Feedbacks and custom reports
• Coding status reports on daily, weekly and monthly basis

Well-organized radiology coding outsourcing services help radiology medical practices, individual practitioners and group practices to enhance their efficiency and revenue at the same time. If you plan to outsource your radiology medical coding tasks, it is important to locate an established medical coding company offering consistent solutions at affordable charges.

Without proper medical coding, it is very difficult to get reimbursement for your medical claims. Insurance companies, whether government or private, accept insurance claims only if the codes are correct. So, accurate medical coding is in high demand nowadays. Healthcare facilities and individual physicians can hire professional medical coding companies for precise and accurate medical coding.

Outsourcing medical coding will considerably reduce the workload of medical practitioners and help them focus on patient care and related core activities.

• Errors like under coding and over coding result in lost revenue, denials and reviews by the insurance service provider. Medical coding companies help medical practices eliminate coding errors.
• Allows healthcare professionals to focus on medical practice instead of other functions.
• Reduces payroll and operational costs
• Improves cash flow and better collections
• Maximizes office efficiency and economies of scale
• Provides maximum reimbursement
• Reduces the chances of denial from insurance companies
• Improved patient and physician satisfaction
• Automated claims generation and electronic submission
• Reduces staffing issues and training time
• Decreases your telephone and postage expenses
• Improves revenue
• Reduces paperwork which in turn increases the productivity and job satisfaction.
• Provides follow-up on all rejected and denied claims
• No need to worry about turnover and personnel problems among the coding staff
• Eliminates overhead expenses of purchasing, upgrading and maintaining computer hardware as well as software
• Free resources for other purposes
• Reduces labor cost
• Eliminates technical support costs
• Provides access to state-of-the-art technology
• Complete control over the financial affairs of your medical practice
• 24 X 7 customer support
• Affordable – charges based on the specialty and size of the practice
• 100% accuracy of medical coding

Today, every healthcare practitioner looks for the support of medical coding specialists to get various benefits including improved cash flow. It can be done in two ways – either hiring a medical coder or hiring a medical coding company. But assigning your medical coding requirements to medical coding companies is the better option as it is highly affordable and helps you in different ways to boost your office efficiency.

Has your cash flow suffered because of under coding and over coding? Outsourcing the medical coding tasks to established professional medical coding companies with skilled workforce, the right processes and the state-of-the-art technology can provide a wide range of benefits to healthcare facilities, one of the main being improved cash flow.

How Medical Coding Companies Can Improve Your Cash Flow?

Medical coding companies help improve the cash flow of healthcare facilities in the following ways:

• By reducing the cost of medical coding: Medical coding outsourcing reduces the direct and indirect cost associated with medical coding significantly. Operating cost that would have been incurred for in-house medical coding can be saved and invested in the core business, thus improving productivity as well as profit.

• By increasing the productivity of healthcare professionals and support staff: Medical coding companies help healthcare professionals to focus more on providing healthcare to patients which results in increased productivity. This in turn helps save on valuable time, efforts and results in better revenues due to improvement in services.

• By providing the basis for reimbursements: Accurate and timely medical coding solution enables quick reimbursement. Creation of accurate patient records on a timely basis ensures that the coding can take place on time and this would speed up the reimbursement process, thus improving cash flow.

Besides improving cash flow, medical coding companies offer a wide range of benefits including reduced administrative responsibilities; and allow medical professionals to focus on core functions, especially patient treatment. In addition, hiring medical coding companies does not require you to set up proper infrastructure and equipment which may cost you much higher.