ED Coding & Reimbursement Alert - 2011 Issue 35
Part B Revenue Booster: Keep Money Flowing With These 6 Income Opportunities
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Article Overview
This article is aimed at medical practices that bill Medicare Part B and want to reduce avoidable revenue loss. It covers broad operational areas such as diagnosis coding updates, documentation support for E/M services, skilled nursing facility billing considerations, supply billing, new-physician enrollment timing, and follow-up on unpaid or denied claims. The discussion is relevant to physicians, coders, billers, and practice managers seeking a practical overview of Medicare-related revenue protection issues.
Why This Topic Matters
These topics can affect whether claims are paid correctly, delayed, or denied, making them important for maintaining Medicare revenue and compliance.
Article Sections
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Update Your ICD-9 Codes
Discusses annual diagnosis-code updates and their role in supporting medical necessity for Medicare claims.
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Ensure That Your Nurse's Notes Are Ironclad
Covers documentation responsibilities for E/M services, including the roles of nursing staff and treating clinicians. It also references guidance from Medicare contractors.
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Stay on top of SNF patient status
Addresses billing concerns when patients are in skilled nursing facility status and the need to coordinate services and claims appropriately.
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Bill your supplies, when reimbursable
Reviews general supply-billing considerations under Medicare and mentions supply-related HCPCS coding for certain casting and splinting items.
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Don't wait to get your new physician credentialed
Explains enrollment timing considerations for newly added practitioners and the implications for Medicare billing back to an earlier date.
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Follow Up on Unpaid and Denied Claim
Focuses on denial management, follow-up processes, and reviewing payment information to identify missed revenue opportunities.
What You Will Learn
- How Medicare Part B revenue can be lost through documentation, billing, and enrollment issues
- Why diagnosis coding and medical necessity documentation remain important for claim payment
- What broad documentation topics are associated with E/M history and nurse-entered information
- How skilled nursing facility status can affect billing workflow
- When certain supplies may be separately billable under Medicare
- Why prompt practitioner enrollment can matter for retroactive billing
- How denial follow-up and EOB review can help practices identify unpaid revenue
Who Should Read This
- Physicians
- Medical coders
- Medical billers
- Practice managers
- Revenue cycle staff
Codes Discussed
Modifiers Discussed
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