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Physicians ought to review the direct monetary impact as several of the managed care contracts can pay these auxiliary services at the CMS RVU rates. the great news is they aren’t set in stone; so doctors can discuss the projected WRVUs or the other a part of the rule until September 27th.
The post RUC & CMS: The Difference Between Them Could Mean Money To Doctors appeared first on The Coding Network.
I spoke with the Maternity Care group that pays for AL Mediciad OB Global to ask how to bill them and was informed that the physician will have to bill the OB Global and the NP will need to be reimbursed from that office. I believe that we need to bill all payers this way.
We had an OB/GYN that left last July so all his patients had to transfer. I had to do a lot of antepartum billing for him. Certain payers such as BCBS denied the claims requiring me to list the Antepartum span dates from the First (New) OB visit to the last visit. Under this new set up, we will have overlapping dates of service between the two pactice locations. The NP will see the OB patients from the New OB until 20-24 weeks. The patient will go to the Physician’s office one time between 20-24 weeks then back to the NP. The patient will be treated by the NP until 35 weeks. At 35 weeks and after, they will go to the Physician’s office until delivery. Since we will have overlapping dates, I cannot enter these dates on the claim, since the claims will deny for overlapping services.
Originally, this was supposed to be Cash pay patients that only had Emergency Medicaid that would cover the delivery. We would charge a set cash price for each antepartum visit (at either office) and the physician would bill Mediciad for the Delivery. Our set up is fine in this situation.
Now, they are marketing to patient’s in the (rural) area that have insurnce and BCBS is a big provider in the area. This has now complicated the OB Global billing, since we have two separate locations under different NPI/Tax ID’s. Help!
I believe that all insurred patients should be billed by the physician and that office have a contract on what to reimburse the NP services for. I need confirmation for this, and I have a feeling that this type of set up has not been done before which makes setting up the charges and billing for this a bit challenging.
I appreciate any help I can get.
Rose Patterson :confused:
Description of Procedure (Main Part)
An in and out catheter was then placed to empty the bladder of all urine. Next, a weighted speculum and Sims retractor was placed in the vaginal area. The cervical os was then carefully dilated. After adequate dilation, a uterine sound was performed with the findings noted above. A10 mm curved suction cruet was then carefully introduced into the uterine cavity and removed of its contents. A sharp curettage was then performed until a gritty texture was noted. Additional passes of the suction curet removed remaining uterine contents. A ring forceps was also placed under ultrasound guidance in the uterine cavity and remained fetal tissue. Excellent stasis noted. All instruments were removed from the vaginal area. Whats the difference in surgical and induced?
Learning to perform coding audits is an important piece of an effective compliance program; but, what’s the difference between internal and external coding audits? An internal audit is one that is performed by members of the organization or practice. Some large hospital systems have an internal audit department that is responsible for auditing all aspects […]
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