Some of the most commonly missed charges in the billing arena are those charges that have to come in pairs. So in other words, one is not payable without the other. Some examples are:
Blood transfusion without the blood product,
or the blood product without the transfusion.
The medical staff are so busy with the patient care that they enter one without the other all the time. A few more examples are:
Flu injection without the flu vaccine, or the vaccine without the administration charge for the shot.
MRI without the radiopharmaceuticals.
Many surgeries also have the same types of problems. For example, surgery for insertion of a pacemaker, without charging for the pacemaker. Believe it or not, claims will deny for this. Medicare actually has a spreadsheet that they keep up to date called the device-to-procedure edits. There are tons of procedures that cannot be billed without the coordinating device, supply, or medication. And most often that second part of the charge is performed, but neglected to be added to the claim.
Your job, as a medical billing professional is to make sure that these charges are all entered correctly and timely. Make sure that your billing software has edits in place to catch these. You can actually collect more money, or at the very least, prevent denials and rebillings.
Until next time:
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Author, Medical Billing, Coding, and Reimbursement
A medical billing professional for over 30 years now, I have seen a lot of changes in this field, and there are a lot more on the horizon. Follow me as we see what they mean and for who.