Inpatient discharge coding
Hey everyone, for those of you who are inpatient consultants, not the primary physician, how do you charge for the day of discharge?
I have been billing as a follow up however I am helping more with discharge paperwork, DME and coordinating with case management and the patient. This made me wonder if I could charge for a discharge code instead of the follow up.
What are the guidelines for this? Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - April 5, 2024 Category: Universities & Medical Training Authors: redfish1891 Tags: PM&R Source Type: forums
Billing tips for newly minted Rheumatology Attending
Im a very short time fellowship will be over and we will be set free to join the workforce as independent providers. Like in most residences and fellowships, billing is not exactly a topic that gets covered a lot. My fellowship is largely academic so attendings often don't think or worry about RVUs.
Currently, I bill mostly 99204/99214, occasionally 99205/99215, G2211, and procedure codes for aspiration/injection. Once I get MSK US certified, I plan on incorporating that into my practice...
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Source: Student Doctor Network - March 18, 2024 Category: Universities & Medical Training Authors: Residentdoc86 Tags: Other Subspecialties Source Type: forums
Consequences of "overbilling"
I see a lot of variety in critical care billing practices. For example, I see some docs are routinely billing critical care time for anyone in the ICU even if stable and going to floor or home that day or totally hemodynamically stable just there for q1h glucose checks for DKA with insulin gtt.
Is it recommended to just err on the side of billing for critical care and if it doesn't meet criteria the coders or insurance company will just change it to non-critical care? If lots of physicians...
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Source: Student Doctor Network - March 5, 2024 Category: Universities & Medical Training Authors: Student3322 Tags: Critical Care Source Type: forums
Cash Flow Disruption due to Change/United Health Cyber-Attack
https://www.washingtonpost.com/business/2024/03/03/change-health-care-hack-hospitals/
Temporary Funding Assistance
"At his solo practice in southern New Jersey, Craig Wax said his billing is “backward, upside-down and on fire.” The doctor cares for patients of all ages and accepts multiple types of insurance, relying on a small billing company that uses a software provider...
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Source: Student Doctor Network - March 4, 2024 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Billing For bilateral Facet Injections
Lets say you do a three-level bilateral lumbar facet injection (L3-4, L4-5, and L5-S1). Is the 50 modifier only applied to the first level (64493) or is it applied to the other two levels (64494 and 64495). I was going over my compensation reports and it looks like my organization is only crediting me for the 50 modifier for the 64493 and not for the 64494 and 64495 meaning that I am not getting the wrvu for doing bilateral for the other two joints. (Source: Student Doctor Network)
Source: Student Doctor Network - March 1, 2024 Category: Universities & Medical Training Authors: donaldduck Tags: Pain Medicine Source Type: forums
Billing E/M or therapy codes with ECT?
Hey everyone, I'm a PGY-4 on an ECT rotation and had a question about billing.
Bit of a preamble first: Our service starts at 7am with pre-evaluations including interval H&P, medication reconciliation, assessment of side effects from ECT, and evaluation for adjustment of dose or electrode placement. 6-10 patients per morning until about 11am-12pm depending on anesthesia. We then perform the procedures and end up having to write both (1) an Interval HPI note (indicating history assessments...
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Source: Student Doctor Network - February 18, 2024 Category: Universities & Medical Training Authors: Hash Slinging Slasher Tags: Psychiatry Source Type: forums
SNF/SAR Private Practice for PM & R Docs
I've been seeing a lot of talk recently about SNF/SAR work from PM&R attendings and residents. There's a couple big companies that I've seen offer splits (always majority in our favor like 70% collections we keep) on a 1099 but why not just go to the facility directly and set things up? Does anyone do this? You get your own billing service, malpractice etc. and bill directly which would yield a much better split in our favor. Why allow these middlemen companies to take a cut? I understand...
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Source: Student Doctor Network - February 18, 2024 Category: Universities & Medical Training Authors: vit8bsm Tags: PM&R Source Type: forums
Reasonable compensation for outpatient gig
Hi all,
I have been seeing patients at an outpatient practice part time in addition to my main inpatient job.
I receive a 70/30 split on revenue generated (billing mostly 99214s+90833s for my established patients). I've had a consistently positive experience with the clinical support staff and enjoy working with the patients I am seeing. However, the 30% if a significant cut and my understanding is that private practice overhead would be around 15-20%.
I'm curious what people's thoughts...
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Source: Student Doctor Network - February 17, 2024 Category: Universities & Medical Training Authors: curiousmindset Tags: Psychiatry Source Type: forums
Ethical Dilemma in Billing
I have an ethical dilemma that I need help with.
I am an Endocrinologist, who lives in a neighboring state to my sister and mother. I am DPoA for medical affairs for my 90 year old mother with moderate Alzheimer’s Disease. My sister, who my mother lives with, is DPoA for finances and pays the bills. My mother has both Medicare part A and B and Federal Blue Cross Insurance. She fell, fracturing her pelvis through the right acetabulum (and ilium), which was repaired surgically. She is...
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Source: Student Doctor Network - February 14, 2024 Category: Universities & Medical Training Authors: Barry1960 Tags: PM&R Source Type: forums
Hospital wants us to admit dead patients
So our notortiously understaffed and underresourced inner city ED just hired a new chairman who previously worked at the well resoured Ivy league ED across town. Since he’s stared over the last few months his main focus has been to increase revenues by any means possible by further increasing billing. This has led to some ridiculous highly questionable department policies centered around critical care.
Now his newest policy is to have us admit cardiac arrest patients even if they’ve been...
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Source: Student Doctor Network - February 4, 2024 Category: Universities & Medical Training Authors: alpinism Tags: Emergency Medicine Source Type: forums
Endo billing
Hey all,
Question for those of you who are endocrinologists.
Spouse is currently finishing up his stay at LTACH after ICU admission
Diabetic, normally was very well managed
Anyhow, primary doctor consulted pretty much everyone including Endocrine. Endocrine doctor saw him 1-2 times and then reviews his chart, and bills for encounters without seeing him. Says he sees him but doesn't. Is this legit?
Do Endocrine docs bill without seeing patients/is that allowed? Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - February 3, 2024 Category: Universities & Medical Training Authors: Iamnew2 Tags: Other Subspecialties Source Type: forums
billing
Hi Anesthesia friends,
I have a question about billing.
when a CRNA does a case and has "supervision" - do you send out two bills?
We recently had our insurance billed $2700 x 2 for CRNA and physician billing for an hourlong procedure - seems rather not legit.
What is the rate typically for anesthesia services for docs and CRNAs? (Source: Student Doctor Network)
Source: Student Doctor Network - January 30, 2024 Category: Universities & Medical Training Authors: Iamnew2 Tags: Anesthesiology Source Type: forums
Billing-new code
Anyone have experience with the G2211 code- do you use it with new patients or follow ups or both? Which types of patients are you using it for? Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - January 25, 2024 Category: Universities & Medical Training Authors: hehe5347 Tags: Hematology / Oncology Source Type: forums
SCS Headaches
I would love to do PNS for occipital neuralgia however insurances currently do not cover for the most part. I know there’s a clinic doing them and have four leads placed (2 greater occipital nerve and 2 supraorbital). I’m not sure how they get reimbursed for this.
I’m considering placing leads in posterior occipital region and billing SCS for C2 radiculopathy.
Thoughts? (Source: Student Doctor Network)
Source: Student Doctor Network - January 13, 2024 Category: Universities & Medical Training Authors: PainBrain78 Tags: Pain Medicine Source Type: forums
Occasional optho coverage
I'm friends with the nurse manager of a local optho center. She's asked if I can cover a few days a month when they can't get a CRNA. They've offered to either let me do my own billing or suggest an hourly rate. This would be a 1099 deal and I would need my own malpractice coverage.
I've never worked on my own like this so I'd love some advice on how to get this going properly. Specifically, what information would I need to decide between billing myself or taking an hourly rate? I'm...
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Source: Student Doctor Network - January 5, 2024 Category: Universities & Medical Training Authors: IDGARA Tags: Anesthesiology Source Type: forums
