Medical Billing Service News – Bill High Level Codes When Warranted

Picture of Meet the Physician Billing Service Team Located in Burke VA

As a leading medical billing company, we frequently report on high-value medical billing service news that provides essential insights for Physicians and Medical Practices.  Today, Physicians Billing Service would like to alert you to the billing of high level codes when warranted.

Physicians and Medical Practices work very hard to provide a standard of excellent care to their patients, whether minor problems or major problems.  As such, medical billers should act with confidence in using high-level medical billing codes when the treatment and situation warrants it.  Under coding claims for complex patient situations with multiple problems, is only doing your medical practice a disservice.

SuperCoder Bolt published an article entitled ‘E/M Coding:  Don’t Shy Away from Billing High-Level Codes When Warranted’, by R. Pandit, that provides an example scenario that was “submitted to Pediatric Coding Alert” as an example scenario of where “coding went wrong”.  The article presents a case of a nine year old patient, with wrist pain and nasal congestion.

In a very detailed and impressive scenario, the author notes, as an example, that “chart was undercoded for this patient since the chart qualifies for reporting 99214. The detailed history, detailed exam, and moderate complexity medical decision-making all support 99214.

Because 99213 pays about $72 and 99214 reimburses approximately $107, this physician forfeited about $35 by downcoding the visit by one level.”

To avoid under coding and to garner confidence in using high level codes, the author advises that “can avoid this same fate by carefully calculating the amount of history, exam, and medical decision-making documented in your charts.”

As many Physicians and Medical Practices can attest, medical billing and collection is becoming increasingly complex with the advent of the Affordable Care Act and Training for ICD-10.  Physicians Billing Service, owned by Michelle Stahl, has been providing award-winning medical billing services since 1989.  She would be glad to provide your medical practice with a free consultation to discuss outsourcing medical billing to the right firm.  Ask about our No Hassle Outsourcing program, Physician references, and track-record.

Physicians Billing Service supports leading Medical Practices from coast-to-coast (including: Northern VAMarylandLeesburg VALandover MDHerndon VA) with Outsourcing Medical Billing.

By Michelle Stahl, Owner, Physicians Billing Service

You can Find Michelle Stahl, Owner of Physicians Billing Service on Google+

About Us

We are proud to support leading Physicians & Medical Practices through-out Florida, Maryland, Washington DC, Virginia, Pennsylvania, New Jersey & New York. Your commitment to excellence inspires us! Since 1989, Physicians Billing Service has been committed to excellence in Medical Billing & Collections.

Contact Us

6035 Burke Center Parkway, Suite 390, Burke VA, 22015. Call (703) 978-0756. Fax: (703) 978-7762.
Contact Michelle Stahl, Owner