Our family practice routinely sees patients after they've been treated in the ED for lacerations, fractures, and similar injuries. We've recently seen an increase in claim denials for such services because the ED physicians are billing for complete care for procedures, even though we're doing the follow-up. What can we do?

Coding modifiers are often underused, misused, or submitted without supporting documentation. Here's how to end these costly mistakes.

One of our physicians was called to active duty earlier this year. We've hired a substitute doctor and plan to bill his services as a locum tenens physician. Our concern is that we can only do this for 60 days. Do we need to find another replacement after that time has elapsed or can we ask for an extension?or discharge and rehire the same locum tenens doctor?

Our practice has never billed for extended visits, but we often spend a great deal of time counseling patients. How do we go about reporting extended visit codes? What else needs to be documented besides the history, exam, and medical decision-making?

Our surgery practice has a satellite office in a nearby hospital. We report place of service 11 (office) for the E&M services we provide at that location, but our Medicare carrier recently notified us that because we're located in an outpatient hospital facility, we should be specifying place of service 22 (outpatient) instead. Is this correct?

We've been using the NPI on our electronic claims for several months without a problem. Suddenly we've begun receiving rejections from virtually every commercial insurer. Our clearinghouse indicates that the problem is the information contained in the NPPES (NPI) files, but we've scrutinized these files for each of our providers and corrected any misinformation and are still having problems with claims. Is there an issue we're unaware of?

I'm a PA, employed by a company owning multiple skilled nursing facilities in our city. I don't have provider numbers with various insurers, but I see patients with the oversight of an MD who's not always onsite. My services are being billed with the provider numbers of the "supervising" physician. I'm new to practice, so I'm not sure whether this is a problem? Is it?

Our practice has been using immunization codes 90465-90468 for patients who are 8 or younger and 90471-90474 for older patients, but we were recently told that this is incorrect. Can you tell us what's wrong and how to fix it?

I'm employed by a large group practice in a resort community that participates in Medicare. Several resort owners have asked me to provide weekend and evening care to vacationers. They'll inform anyone who wishes to use my services that I take cash only and will not bill third-party payers. They also suggested that I set my fees to "adequately compensate" me for being on call. Is this is too good to be true?