Starting a Medical Billing Business > Starting Your Own Medical Billing Business
Managing Time
jcbilling:
I'm curious where the line is drawn when billing for clients without doing any coding.
Without being a certified coder, is adding modifiers to codes when the visit notes permit us to do so considered coding?
~ Charity
PMRNC:
--- Quote ---Without being a certified coder, is adding modifiers to codes when the visit notes permit us to do so considered coding?
--- End quote ---
that would depend on the experience/knowledge of the biller. I will add modifier but I have the provider or the office sign off on any changes or additions, that's just to Cover my butt.
Pay_My_Claims:
that's why I love DME :-)
Michele:
You shouldn't change or add anything without clearing it with the provider, or provider's office staff (if they have someone there that has authority to do so). Even just adding a modifier.
Michele
Pay_My_Claims:
and that is the difference with DME. In order to Bill you have to know how to code the item, and the proper usage of modifiers. The manufacturer they order the custom chair from will have a spec sheet and it does lists the codes, however when you are billing out per sey a rental, you have to know which modifier to bill to justify which month they are paying. You have to know when to use the KX modifier, keep up with the changes in codes etc. Now like medical billing, I can't change or add a DX just to justify a cushion. If the dx does not warrant the person having the specific cushion that was ordered, i would contact the provider to see if the client signed an ABN or possibly paid up-front. Even checking with the MD to determine if he had a specific reason why he ordered the cushion. Additional documentation can justify to Medicare why they had to order a pressure-relieving cushion to someone who's primary dx just doesn't justify it according to medicare guidelines.
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