About MZ Medical Billing Specialties

MZ Medical Billing: A Beacon of Expertise

MZ Medical Billing stands as a beacon of expertise in medical billing, particularly excelling in the dynamic field of Emergency Medicine billing. Here's why MZ Medical Billing is the go-to choice for healthcare providers seeking precision, compliance, and optimal reimbursement in Emergency Medicine billing:

Comprehensive Understanding of Emergency Medicine Billing Guidelines

1. Expert Team: Our seasoned team is well-versed in the intricacies of Emergency Medicine billing.
2. Accuracy and Compliance: We ensure adherence to the latest coding standards and regulations.
3. Complex Coding: From critical care services to trauma procedures, we handle the complexities with finesse.

Strategic Reimbursement Optimization

1. Maximize Reimbursements: We employ strategic approaches to maximize reimbursements for Emergency Medicine services.
2. Minimize Risks: By meticulously documenting and coding procedures, we reduce the risk of claim denials and audits.
3. Consistent Revenue: Our proactive approach ensures a steady revenue flow for healthcare providers.

Nationwide Awareness of State-Specific Guidelines

1. State-Specific Knowledge: We recognize the importance of understanding varying state guidelines.
2. Tailored Approaches: Our approach is tailored to ensure compliance and prevent penalties, regardless of geographic location.

Integration of Advanced Technology

1. Cutting-Edge Systems: We leverage state-of-the-art software to streamline the billing process.
2. Automated Claims Submission: Our systems enable automated claims submission and real-time tracking of reimbursements.
3. Seamless Integration: We integrate smoothly with healthcare providers' existing systems, enhancing efficiency and accuracy.

Personalized Client Support

1. Dedicated Team: We prioritize personalized support to address the unique needs of healthcare providers.
2. Ongoing Assistance: Our team offers ongoing assistance, promptly resolving queries and providing proactive guidance.

Our Medical Billing Process

Patient Registration and Insurance Verification

1. Patient Registration: Verify patient demographics, including name, date of birth, and address.
2. Insurance Verification: Verify patient insurance coverage, including type, coverage limits, and any specific requirements or restrictions.

Medical Record Review and Coding

1. Medical Record Review: Identify all relevant services and procedures performed.
2. Coding: Assign relevant ICD-10 and CPT codes for accurate billing.
   • Diagnosis Codes (ICD-10):
     • S72.01: Fracture of the femur, initial encounter
     • S82.01: Fracture of the tibia, initial encounter
     • S83.01: Fracture of the fibula, initial encounter
   • Procedure Codes (CPT):
     • 99281: Emergency department visit for a non-complex condition
     • 99282: Emergency department visit for a complex condition
     • 99283: Emergency department visit for a critical condition

Claim Preparation and Submission

1. Claim Preparation: Prepare claims using coded information, including patient demographics, insurance information, and services and procedures performed.
2. Claim Submission: Submit claims to insurance providers electronically or on paper.

Claim Processing and Reimbursement

1. Claim Processing: Insurance providers process claims, verifying services and procedures performed and patient insurance coverage.
2. Reimbursement: Insurance providers reimburse for services and procedures based on coverage and contracted rates.

Follow-up and Appeals

1. Follow-up: Ensure claims have been processed and address any issues or denials.
2. Appeals: Work with the provider to gather additional information and appeal denied claims.

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Emergency Medicine CPT Codes

• Emergency Department Services
  • 99281-99285: These codes represent the five levels of emergency department services, with increasing complexity and medical decision-making. The levels are:
    • 99281: Emergency department visit for the evaluation and management of a patient with a non-complex condition, with a level of medical decision-making that is straightforward and uncomplicated.
    • 99282: Emergency department visit for the evaluation and management of a patient with a non-complex condition, with a level of medical decision-making that is straightforward and uncomplicated, but with a higher level of complexity than 99281.
    • 99283: Emergency department visit for the evaluation and management of a patient with a non-complex condition, with a level of medical decision-making that is straightforward and uncomplicated, but with a higher level of complexity than 99282.
    • 99284: Emergency department visit for the evaluation and management of a patient with a non-complex condition, with a level of medical decision-making that is straightforward and uncomplicated, but with a higher level of complexity than 99283.
    • 99285: Emergency department visit for the evaluation and management of a patient with a non-complex condition, with a level of medical decision-making that is straightforward and uncomplicated, but with a higher level of complexity than 99284.

Place of Service Codes

• 23: Emergency Room. – Hospital. A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided.

ICD-10-CM Diagnosis Codes

• These codes are used to diagnose and classify medical conditions. For emergency medicine, common ICD-10-CM diagnosis codes include:
  • S00-S09: Injuries to the head, face, and neck.
  • S10-S19: Injuries to the thorax.
  • S20-S29: Injuries to the abdomen.
  • S30-S39: Injuries to the lower extremities.
  • S40-S49: Injuries to the upper extremities.
  • S50-S59: Injuries to the back and spine.
  • S60-S69: Injuries to the pelvis and perineum.
  • S70-S79: Injuries to the lower back and spine.
  • S80-S89: Injuries to the upper back and spine.
  • S90-S99: Injuries to the face and head.

CPT/HCPCS Procedure Codes

• These codes are used to report medical procedures and services. For emergency medicine, common CPT/HCPCS procedure codes include:
  • 99281-99285: Emergency department services.
  • 99291-99292: Critical care services.
  • 99293-99294: Observation services.
  • 99295-99296: Consultation services.
  • 99297-99298: Other services.

Billing and Coding Guidelines

• The Centers for Medicare and Medicaid Services (CMS) provides guidelines for billing and coding emergency medicine services. These guidelines include:
  • **Using the correct place of service code (23) for emergency department services.
  • **Using the correct CPT/HCPCS procedure codes for emergency department services.
  • **Using the correct ICD-10-CM diagnosis codes for emergency department services.
  • Following the CMS guidelines for billing and coding emergency department services.

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