MES - Midwest Emergency Services, LLC

By: James M. Fox, M.D., M.B.A., F.A.C.E.P. and Sandra A. Steele, C.P.C., C.P.M.A., C.E.D.C.

It is important to complete your procedure note shortly after the procedure so that essential information is documented.  Details of the procedure will help your coder to assign the correct CPT code and receive the maximum, allowable reimbursement for your services.

By: James M. Fox, M.D., M.B.A., F.A.C.E.P. and Sandra A. Steele, C.P.C., C.P.M.A., C.E.D.C.

It may have been a while since you last reviewed your fee schedule.  Many physicians in Michigan have been sensitive to the economy in our state and have not updated their fees for a number of years.  Once again, Congress has passed short-term Medicare Program extenders that have temporarily stopped the expected 27.4% cut to your payments for 2012.

By: James M. Fox, M.D., M.B.A., F.A.C.E.P. and Sandra A. Steele, C.P.C., C.P.M.A., C.E.D.C.

You may be missing out on a significant amount of revenue because you are not documenting critical care services or you could be identified as a provider that reports this code above what is “usual”.  The most recent Medicare data indicates that Michigan emergency physicians are reporting 6.31% of their services to Medicare as critical care. 

By: James M. Fox, M.D., M.B.A., F.A.C.E.P. and Sandra A. Steele, C.P.C., C.P.M.A., C.E.D.C.

Did you know that the Health Insurance Portability and Accountability Act (HIPAA) turned 15 years old in August?  After all these years there is yet another very important HIPAA compliance deadline for billing that needs to be met by the end of this year.  On January 1, 2012 all claims sent must meet a new set of standards for electronic submission.  CMS (Medicare) has made several statements that they will not draw back from the January 1^st deadline.

By: James M. Fox, M.D., M.B.A., F.A.C.E.P. and Sandra A. Steele, C.P.C., C.P.M.A., C.E.D.C.

The repair of a laceration is one of the most common surgical procedures performed in the emergency department.  CPT provides codes for three types of laceration repairs: simple, intermediate and complex.  Coding for these repairs can be confusing unless the physician’s procedure note clearly identifies several items.  The procedure note should contain the following information to allow the most accurate code to be assigned for the service provided:

By: James M. Fox, M.D., M.B.A., F.A.C.E.P. and Sandra A. Steele, C.P.C., C.E.D.C.

Have you considered scheduling a review of your coding/billing service?  It is very common to schedule a yearly review of the coding of your charts.  A review or audit of the billing and posting of payments should be a part of your business compliance plan and can be as important as the other regular reviews that take place within your business.