ED Coding & Reimbursement Alert - 2009 Issue 3
Part B Revenue Booster: 2 Tips Easily Solve Your Code Compliance Errors
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Article Overview
This article is a short compliance-focused guide for Part B billing staff, coders, and physician practices. It explains two common error areas that can trigger denials: reporting of professional and technical components for diagnostic testing, and the distinction between reciprocal billing and locum tenens modifier use. The article is designed to help readers recognize where these issues arise in practice and understand the general categories of guidance being discussed.
Why This Topic Matters
These issues can affect claim acceptance, correct provider reporting, and denial prevention in physician billing workflows. The article is relevant to practices that bill diagnostic services, use substitute physicians, or submit Medicare claims in facility and office settings.
Article Sections
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Tip 1: Beware of Tricky PC/TC Components
Discusses reporting issues related to professional and technical components for diagnostic services in facility settings. The section explains a common compliance mistake and the context in which the guidance applies.
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Tip 2: Be Careful Coding Locum Tenens
Covers substitute physician billing arrangements and the distinction between two common billing scenarios. The section focuses on compliance concerns for claims submitted under Medicare rules.
What You Will Learn
- How this article frames common Part B compliance errors
- Why professional and technical component claims can be confusing
- How substitute physician billing scenarios differ in general
- What kinds of situations can lead to denials or reporting mistakes
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Compliance teams
- Medicare claim submitters
Codes Discussed
Modifiers Discussed
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