Medical Billing for Neurology

Medical Billing for Neurology

Medical billing is the procedure by which healthcare agencies submit and follow up on claims to insurance companies for healthcare services. It is a two-way contract between insurance agencies and medical practitioners. In order to do this, medical practices hire what are called a Medical Billing Neurologymedical insurance specialist that will handle all aspects related to billing, insurance, and collection of payment.

Medical Practice Management Resources works with a lot of neurology practices on medical billing. The company has experts in medical billing for neurology.

The specialist uses specific codes for any procedures that are run during a patient’s visit. These codes match up to specific item numbers according to the ICD-10-PCS, which lists the codes and their equivalent meanings. The structure of the ICD-10 consists of alphanumeric characters that represent different procedures and diagnoses.

ICD-10 Coding Structure

  1. The first character is representative of the category under which the procedure falls. For example, the number 0 represents the Medical and Surgical category, 1 represents Obstetrics, and B represents Imaging.
  2. The second character represents the body system the procedure or diagnosis affects. The Central Nervous System is coded 00; the Peripheral Nervous System is coded 01; etc. Each character builds upon the one that came previously.
  3. The third character is determined by the root operation.
  4. The fourth is established by the body part being affected.
  5. The fifth character is decided by the approach to the procedure, which is open or percutaneous.
  6. The sixth character is determined by the device used to perform the procedure.
  7. The seventh character is used as a qualifier in order to provide the biller with any other pertinent information about the procedure.

Coding for Neurological Procedures

Neurological procedures can fall under different categories, namely medical/surgical or mental health. The category that begins the first character of the code depends on what sort of diagnosis is assigned to the patient. Neurology Medical Billing

The diagnosis of Alzheimer’s, for example, would contain procedures that fall into the mental health category and would be denoted with a “G” at the beginning of its code. If the patient were diagnosed with a hemorrhage, on the other hand, the code for any procedures would begin with a “0” denoting its place in the medical/surgical portion of the coding system.

In the case where a patient needs to undergo a brain mapping procedure, that procedure would be marked as 00K00ZZ, 00K03ZZ, or 00K04ZZ for billing purposes, depending on the circumstances surrounding the procedure. The first “0” signifies the code for a medical and/or surgical procedure, and the second “0” shows that it is in the Central Nervous System, which is the system of the body that contains the brain.

The “K” indicates that the operation being performed is a mapping operation. The next “0” represents that the part of the body that is being operated on is the brain. The next character is where the procedure code changes according to the way in which it is performed. If the procedure has a “0” as its fifth character, it means that the operational approach is open. If it has a “3” as its fifth character, it means the operational approach is percutaneous. If it has a “4” as its fifth character, it means the operational approach is percutaneous endoscopic.

The sixth character is a “Z” in this case, denoting that no device was used during the procedure. The final character is also a “Z” noting that a qualifier was not required for the procedure. This Medical Billing Neurologyunique and specific code allows the billing specialist to bill a patient’s insurance company for the correct procedures.

It is important to recognize the billing codes for specific therapies when it comes to billing for neurological procedures. Each character of the code corresponds to a different portion of the procedure and allows for a more streamlined billing process.

MPMR offers medical billing for neurology and works with practices big and small. With over two decades of experience, MPMR is a top California medical billing company and works with practices across the country!

Resources

http://www.icd10data.com/ICD10PCS/Codes/0/0/K/0

http://www.icd10data.com/ICD10PCS/Codes/0

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