Medicare Compliance & Reimbursement

When your practice is feeling pinched, it’s important to ensure that you aren’t forgetting to bill for everything your practitioner performs and documents. Medicare coding rules are complex and challenging, and sometimes it’s hard to know which services you can rightfully bill. But if you’re up to speed on these seven key billing practices, you’ll be collecting all of the pay you deserve. 1. Keep modifier 50 in mind: Many procedures are inherently unilateral, and youwon’t receive full reimbursement for bilateral versions of those procedures unless you append modifier 50 (Bilateral procedure). Watch out: Coders often forget the 50 modifier for bilateral spinal injection and diagnostic ophthalmology procedures. Check the Medicare Physician Fee Schedule to determine which codes are allowable with modifier 50, and if your physician performs and documents a bilateral procedure for one of those services, be sure and submit your claim for a bilateral service. 2. Collect [...]