Medical care and equipment provided to those with disabilities require coding that is often different from that used for patients with short-term treatment of similar conditions. That means medical coders and billers must be alert to the details of what was done and under what circumstances.
It can be difficult for inexperienced coders—especially in a busy medical office environment—to catch all the details. That’s why we recommend outsourcing medical billing and coding to someone who specializes only in that aspect of the business. Revenue cycle management (RCM) can be handled externally, allowing physicians and medical staff to focus on caring for patients while having highly-trained specialists manage claims.
The following are just a few of the details that make disability medical billing unique. In order to receive reimbursement for services and equipment, the appropriate codes must be applied.
Insurers and payers have differing policies regarding durable medical equipment (DME) and other medically necessary equipment, so coders and medical billers must be skilled in checking the payer’s requirements and specific coverage.
Services for those with disabilities are constantly being upgraded, which means that coding must change to keep up with new developments. In addition to hospital and medical treatment, rehabilitative, residential and long-term care are provided. The rules differ in some cases from those for the elderly who are covered by Medicaid, requiring coders and billers to be attentive to the correct designations.
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