62311 bundled with fluoro

[Pain Applicant1]

Are you guys still billing out the fluoro code with LESI and CESI? Athena doesn't let me put it through but I think some commercials are still paying for it? Anyone billing it out and getting reimbursed?

---

Members don't see this ad.

 

[Taus]

Thought it was only mcare that bundled it for now?

 

[emd123]

All commercials are still paying it around me. Medicare, not.

 

[pmrmd]

We are still getting paid for this from commercials AND Medicare. Waiting for the Noridian reach-back and demand letter for the money.

 

[Stim4me]

Ama billing guidelines still allows 77003. Only Medicare has bundled payments.

 

[Pain Applicant1]

Ouch, that ones gonna hurt. I've been omitting fluoro and contrast code for everyone. Just should've done it for Medicare. Better late than never. Thanks!

 

[Stim4me]

Ouch, that ones gonna hurt. I've been omitting fluoro and contrast code for everyone. Just should've done it for Medicare. Better late than never. Thanks!

Also bill consult codes 99242-5 for commercial plans... AMA allowed, Medicare denied...

 

[mdvol]

I have had one denial from BCBS and plenty from medicare now. i still bill for commercial but not medicare.

 

[knoxdoc]

I don't have a single payor still paying for 77003 with interlaminars. Awesome.

 

[Pain Applicant1]

Also bill consult codes 99242-5 for commercial plans... AMA allowed, Medicare denied...

Consult codes for commercial Haven't done that since I opened up nearly four years ago. Thanks for the tip.

 

[Stim4me]

Consult codes for commercial Haven't done that since I opened up nearly four years ago. Thanks for the tip.

Ouch...

 

[emd123]

Consult codes for commercial Haven't done that since I opened up nearly four years ago. Thanks for the tip.

Make sure you check the allowables. Some commercials don't pay the consult codes. Some that do pay LESS for the consult codes than for new patient codes. A few still do pay extra but you have to have the extra elements required. Make sure you've done this homework.

 

[Pain Applicant1]

Thanks! In all honesty, I'm so burnt out from dealing with this billing that I let so much go. It's just not worth the fight anymore. I think I'd rather make less and not kill myself trying to capture everything. Definitely an effective strategy by the payers.

 

[Stim4me]

I may expand my billing company if people are interested.... lets see what happens with icd 10 first... My collections are very good but you need to be onto of your people...

 

[Papa Lou]

Thanks! In all honesty, I'm so burnt out from dealing with this billing that I let so much go. It's just not worth the fight anymore. I think I'd rather make less and not kill myself trying to capture everything. Definitely an effective strategy by the payers.

Ouch, that ones gonna hurt. I've been omitting fluoro and contrast code for everyone. Just should've done it for Medicare. Better late than never. Thanks!

Wow this from the guy who's preached learning your own billing from the beginning so adamantly. Terrible news. I guess this helps explain why typically coders/billers go after low-hanging fruit but tend to give up the high altitude stuff. It's time for you to finally switch to Athena.

 

[emd123]

I may expand my billing company if people are interested.... lets see what happens with icd 10 first... My collections are very good but you need to be onto of your people...

Yes! Billers will not track down every penny, dollar or even $1,000. You need to constantly be spot auditing, finding what's on hold, why, and follow up, follow up, follow up. I had a work comp patient not too long ago. I was doing a repeat Rfa from six months prior. I spot checked the bill and I hadn't been paid for the previous rfa 6 months ago, previous bilat euflexxa injections, and multiple follow ups. I hadn't been paid ANYTHING on the guy for 1 whole year. Lit a fire under some a$$ess and got it all paid. I don't follow up on every bill, but do random spot audits kind of like the IRS and let everyone know I'm watching. If you're not looking over people's shoulders, this crap happens all the time. After all, it's your money not theirs.

 

[Pain Applicant1]

Wow this from the guy who's preached learning your own billing from the beginning so adamantly. Terrible news. I guess this helps explain why typically coders/billers go after low-hanging fruit but tend to give up the high altitude stuff. It's time for you to finally switch to Athena.

I still recommend doing your own billing. Hiring billers/coders ends up being more work because you have to still audit them. I've already switched to Athena. Athena only helps with billing, you still have to follow up on your own and do your own coding. It's still a lot of work not matter which way you approach it. Doing your own coding/billing is a must, no way around it. You HAVE TO learn coding/billing no matter what.

 

[lobelsteve]

Or see other thread. I will never make a million per year being an MD and seeing patients. My only stress is that of caring for patients. Not keeping the lights on or if the needle is cost effective.

 

[emd123]

I still recommend doing your own billing. Hiring billers/coders ends up being more work because you have to still audit them. I've already switched to Athena. Athena only helps with billing, you still have to follow up on your own and do your own coding. It's still a lot of work not matter which way you approach it. Doing your own coding/billing is a must, no way around it. You HAVE TO learn coding/billing no matter what.

I use Athena too. I do all the coding, but staff (in house billing) drops the bill and chases the money.

 

[emd123]

Or see other thread. I will never make a million per year being an MD and seeing patients. My only stress is that of caring for patients. Not keeping the lights on or if the needle is cost effective.

Aren't you paid on $per/wRVU? If so, you still have to worry about $'s & ¢'s

 

[lobelsteve]

Aren't you paid on $per/wRVU? If so, you still have to worry about $'s & ¢'s

I have a favorable base and benefits package. Rvu only for tracking and limited bonus.

 

[Stim4me]

I have a favorable base and benefits package. Rvu only for tracking and limited bonus.

Doesn't seem like a feasible, realistic, or sustainable reimbursement model... your lack of interest in billing appears unique to you position/situation.

 

[lobelsteve]

Doesn't seem like a feasible, realistic, or sustainable reimbursement model... your lack of interest in billing appears unique to you position/situation.

Thats what i think. Im riding the bus til the wheels come off. And its worse than you can imagine. I must be making someone a mint. Just no idea who.

 

[Ducttape]

You are making the hospital a mint and will be fine... While that lasts.....