Thursday, August 21, 2014

Dial-up customers using 717 area code modem telephone number

REMINDER - Dial-up Customers Using the 717 Area Code Modem Telephone Number – Less Than Two Weeks Left
EDI trading partners still connecting to Novitas via the former 717 area code modem telephone number will no longer be able to connect for claim submission and report retrieval as of 12:01 AM Eastern Time (ET) on Friday, August 29, 2014 – that’s less than two weeks away!

Effective August 29, 2014 at 12:01 AM ET, dial-up trading partners must transition to the new number, 904-371-9510.  We have found that customers who have made the switch to the new dial-up number may need to down speed their modem if they are having difficulties connecting.
The majority of our trading partners have already made these changes, and we appreciate your assistance with this effort.  Currently, customers still connecting through the 717 area code mode telephone number may already be experiencing:
  • Inability to connect for claim submission, remittance and/or report retrieval.
  • Decreased connection quality.
  • Frequent connection time-outs.
If your modem is more than four years old, you may need to purchase a new dial-up modem in order to connect.  Customers who have not changed to the new connections should speak to their software vendor immediately to resolve any connection issues you are experiencing.   Additionally, trading partners who are located in the 717 area code will need long distance phone service in order to connect.
If you have questions regarding this change, please contact an EDI Analyst at the numbers listed below.
EDI Services:
1-877-235-8073, Option 3 (JL)
1-855-252-8782, Option 3 (JH)

Thursday, August 14, 2014

DX For Injury and Poisoning Dx 800 – 999

[800-829] Fractures.
[800-804] Fracture of skull.
[805-809] Fracture of neck and trunk.
[810-819] Fracture of upper limb.
[820-829] Fracture of lower limb.
[830-839] Dislocation.

[840-848] Sprains and strains of joints and adjacent muscles.
[850-854] Intracranial injury, excluding those with skull fracture.
[860-869] Internal injury of thorax, abdomen, and pelvis.
[870-897] Open wound o.
[900-904] Injury to blood vessels.
[905-909] Late effects of injuries, poisonings, toxic effects, and other external causes.
[910-919] Superficial injury.
[920-924] Contusion with intact skin surface.
[925-929] Crushing injury.
[930-939] Effects of foreign body entering through orifice.
[940-949] Burns.
[950-957] Injury to nerves and spinal cord.
[958-959] Certain traumatic complications and unspecified injuries.
[960-979] Poisoning by drugs, medicinal and biological substances.
[980-989] Toxic effects of substances chiefly non-medicinal as to source.
[990-995] Other and unspecified effects of external causes.
[996-999] Complications of surgical and medical care, not elsewhere classified.

DX Code V01 – V82 & E800 – E999

[V01-V06] Persons with potential health hazards related to communicable diseases.
[V07-V09] Persons with need for isolation, other potential health hazards and prophylactic measures.
[V10-V19] Persons with potential health hazards related to personal and family history.
[V20-V28] Persons encountering health services in circumstances related to reproduction and
[V30-V39] Live born infants according to type of birth.
[V40-V49] Persons with a condition influencing their health status.
[V50-V59] Persons encountering health services for specific procedures and aftercare.
[V60-V68] Persons encountering health services in other circumstances.
[V70-V82] Persons without reported diagnosis encountered during examination and investigation of
individuals and populations.

[E800-E807] Railway accidents.
[E810-E819] Motor vehicle traffic accidents.
[E820-E835] Motor vehicle non-traffic accidents.
[E826-E829] Other road vehicle accidents.
[E830-E838] Water transport accidents.
[E840-E845] Air and space transport accidents.
[E846-E848] Vehicle accident not elsewhere classifiable.
[E850-E858] Accidental poisoning by drugs, medicinal substances, and biologicals.
[E860-E869] Accidental poisoning by other solid and liquid substances, gases, and vapors.
[E870-E876] Misadventures to patients during surgical and medical care.
[E878-E879] Surgical and medical procedures as the cause of abnormal
reaction of patient or later complication, without mention of misadventure at the time of

[E880-E888] Accidental falls.
[E890-E899] Accidents caused by fire and flames.
[E900-E909] Accidents due to natural and environmental factors.
[E910-E915] Accidents caused by submersion, suffocation, and foreign bodies.
[E916-E928] Other accidents.
[E929-E929] Late effects of accidental injury.
[E930-E949] Drugs, medicinal and biological substances causing adverse effects in therapeutic uses.
[E950-E959] Suicide and self-inflicted injury.
[E960-E969] Homicide and injury purposely inflicted by other persons.
[E970-E978] Legal intervention.
[E980-E989] Injury undetermined whether accidentally or purposely inflicted.
[E990-E999] Injury resulting from operations of war.

What is CPT 99354 – Prolonged visit

 CPT 99354 – Prolonged physician service in the office or other outpatient setting, requiring direct (face-to-face) patient contact beyond the usual service – first hour (List separately in addition to code for office or other outpatient Evaluation and Management service)

The Medicare Manual says:
The start and end times of the visit shall be documented in the medical record along with the date of service.

This code is one of many under-utilized codes in your office for many reasons. However, if you do the work and spend the prolonged time, face to face with the patient, document the progress note properly and provide the required medically necessary components, you deserve to use this code and get paid for your time.

Serious Illness Takes Serious Time

This code can be used for a seriously ill patient in your office, when you are spending a significant amount of time helping, while deciding the best course of action. This would include deciding to admit the patient to the hospital or sending the patient to the emergency room via a 911 call.

Usually, if you are spending over 40 minutes with the patient and have all of the criteria, you are going to document and bill for a 99215.  However, if you end up spending any additional time, for example, over another 30 minutes with the patient, and your face-to-face total time counting all other services is 75 minutes or more, you may be entitled to capture the additional CPT code 99354.

Record Your Time!

It is prudent to report the start times and the ending times as well as the face-to-face time, in order to properly capture this code.

Overall, this really is not that difficult.  For example, if you have a patient who comes into your office with an exacerbation of their COPD, you may start the patient on oxygen in your office while you perform your History, Physical and Medical Decision Making.

Keep Track of the Intensity of your Care

In the course of this you may order a nebulizer treatment for the patient and then leave the room to see another patient, you should document the time actually spent with the patient up to that point.
Once you return to the room the clock starts again. While speaking with the patient regarding how they feel after the nebulizer treatment, you may decide that they need an injection or another treatment. You document the time and then may have to leave the room to see another patient.

Once you return to the room, the clock starts again; so each time you decide on a treatment option for this patient, you continue to accrue time towards, not only the level CPT 99215 visit as the patient definitely will meet criteria for the intensity and medical necessity, you are potentially capturing the extra time needed to use the CPT 99354 code.
This code will enable you to be able to bill for the extra time you need to spend with the patient while you are stabilizing them, in order to decide if they can return home be transported to the hospital.

Many of us have the occasional patient who will use a significant amount of time in order for you to take proper care of them, to stabilize them and to decide whether the current problem they have can be handled from home or in the hospital.

Code Correctly for your Visit Too

If you provide the care, you deserve the code. That is why it is available in the first place. You owe it to yourself to maximize your revenue. Many providers will only bill this encounter as a CPT 99213 or CPT 99214. The reality is, if you do the work and properly document with the medical necessity in place, you can easily and comfortably bill for the appropriate code CPT 99215 and CPT 99354.

Saturday, August 9, 2014

What is Audio Assessment Test – Interview Round

What is Audio Assessment Test, Few companies started including Audio Assessment Test in Interview rounds; let’s have a quick look about audio assessment test.

Companies just want to assess your language, i.e., Speaking, Listening, Grammar, Typing Speed & Typing Quality etc.,  

Speaking: How good you are in pronouncing English

Listening: Whether you can listen and understand the language

Grammar: Knowledge Basic grammar

Typing Speed & Quality: How good you are in typing speed and quality of your typing.

These are basic thinks they are going to check, most of companies started doing online. Even you can test your skills in online before attend the interviews. If you have Basic English knowledge that is enough still practices before you attend any interview.

Saturday, August 2, 2014

Road to ICD10

CMS has created a website for ICD10 the website was named as to help the healthcare industry to jump start the transition to ICD10. 

Important Features about ICD 10
ICD10 Over view

Specialty reference

Build your action plan

Quick reference about ICD 10


Template Library


It’s very useful website for Medical billing or Health care industry to start the transition to ICD10.

Any Medical billing | Healthcare | US Healthcare | Denial Management | Medical Billing blog | related questions please visit us  :

What is QMB / MQMB stands for?

In Medical billing or Healthcare industry The term QMB stands for Qualified Medicare Beneficiary & MQMB stands for Medicare Qualified Medicare Beneficiary.

The term "QMB" or "MQMB" on the form indicates the client is a Qualified Medicare

 Beneficiary (QMB) or a Medicaid Qualified Medicare Beneficiary (MQMB). The Medicare Catastrophic Coverage Act of 1988 requires Medicare premiums, deductibles, and coinsurance payments to be paid for individuals who meet the following criteria: 

Important: Clients limited to QMB are not eligible for THSteps or THSteps-CCP Medicaid benefits. 

Note: Clients eligible for STAR+PLUS who have Medicare and Medicaid are MQMBs. Medicaid reimburses for the coinsurance and deductibles as well as Medicaid-only services for the MQMB client.

QMBs do not receive Medicaid benefits other than Medicare deductible and coinsurance liabilities. MQMBs do qualify for Medicaid benefits not covered by Medicare in addition to Medicaid payment of Medicare deductible and/or coinsurance.