1. Top 10 Billing Tips Increase your billings without breaking the rules
Dr Hamish Hwang

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4. Bill for everything that you do
Rule Number 1
Bill for everything that you do

5. Don’t bill for anything that you didn’t do
Rule Number 2
Don’t bill for anything that you didn’t do

6. Rule Number 3
Document!

7. Rule Number 4
Document!

8. Rule Number 5
Document!

9. Your friend the note record

11. Top 10 Tips

12. Bill for electronic wound monitoring
Number 10
Bill for electronic wound monitoring
10006 Specialist Patient Follow-Up $10.10
Secure platform medeohealth.com
Post-mastectomy
Chronic wounds
Ostomy follow up
Remote patient
Also supports video followup (70070/70077)

13. Bill 75% for re-prep and drape
Number 9
Bill 75% for re-prep and drape
Type the following into the note record:
“Separate prep and drape payable at 75% as per surgical preamble”
Eg. Sentinel lymph node biopsy and partial mastectomy
Bill at 100% and at 75%

14. Bill for surcharges for scopes done after hours or on the weekend
Number 8
Bill for surcharges for scopes done after hours or on the weekend
Cannot be “scheduled” or “elective”
Emergency only
Can bill surgical surcharges 01210, 01211, and applicable call back 01200, 01201, only if procedure more than 45min
Does not apply to “diagnostic” procedures, only “surgical” procedures

15. “Surgical” endoscopy procedures:
Number 8
“Surgical” endoscopy procedures:
33374 colonoscopy with polypectomy
07460 sigmoidoscopy decompression volvulus
33321 Removal foreign material (upper GI)
33322 Therapeutic injection
33323 Stent or catheter
33324 Thermal coagulation
33325 Gastric polypectomy
33326 PEG tube
33329 Esophageal dilation

16. 78717 Specialist Discharge Care Plan for Complex Patients $75.00
Number 7
78717 Specialist Discharge Care Plan for Complex Patients $75.00
For any inpatient stay 4 days or longer
Now includes elective admissions
Can be billed in addition to 71008
Download template:

17. Number 7

18. Number 7
Enter the form into your EMR or fill-in online and print
Fax to GP’s office and give copy to patient
Bill $75 for 5 minutes work

19. Doesn’t seem like much but it is 37% more
Number 6
Bill instead of for non-operative management of emergency patients
$27.76
$20.28
Doesn’t seem like much but it is 37% more
Bill twice per calendar week – can bill Sat, Sun and then Mon, Tue
Eg, GI bleed, pancreatitis, SBO, cholangitis

20. Number 5
Bill for repeat call backs and continuing care
Call backs 01200, 01201, 01202
If you leave the hospital and come back a second time you can bill again
Don’t bill if you haven’t actually left the hospital

21. Number 5
If you are called back and see multiple patients you can bill continuing care fees 01205, 01206, 01207
You have to be there more than 45min
You must enter into the note record “CCFPP” (continuing care from previous patient)
Eg, patient
Patient ccfpp

22. Diagnostic and surgical procedures done together both billed at 100%
Number 4
Diagnostic and surgical procedures done together both billed at 100%
“Unless specified elsewhere or agreed to at the tariff committee etc, the general interpretation of Preamble B. 11. b is when a diagnostic procedure is performed with a surgical procedure the diagnostic procedure is paid at 100%. If more than one diagnostic procedure is performed with a surgery the 2nd diagnostic procedure is paid at 50%.”

23. Number 4 Eg 33374 colonoscopy/polypectomy + 10761 EGD
Both 100%
10731 colonoscopy hemorrhoid band
71535 lap Nissen EGD

24. Number 3
Bill a hospital visit in addition to diagnostic procedures if last visit is more than 30 days ago
Must enter into note record: “diagnostic procedure done more than 30 days after last visit”
General Preamble D. 7. a.
“A subsequent visit fee will be paid in addition to the procedure if more than thirty (30) days has elapsed between the initial visit or service and the diagnostic procedure.”

25. Does not apply if you do a “surgical” endoscopic procedure like 33374
Number 3
Does not apply if you do a “surgical” endoscopic procedure like 33374 Eg
10761 EGD
10763 biopsy
07008 hospital visit *note record
10731 colonoscopy

26. Number 3
$88.00
$227.15
$20.28
It’s like getting paid 23% more for an EGD and 9% more for a colonoscopy and is completely legit as long as you haven’t seen the patient for more than 30 days

27. 10001 Urgent specialist advice - $60.00
Number 2
10001 Urgent specialist advice - $60.00
Bill for calls from GPs or ER for patients that you do not see the same day
Need patient name, PHN, DOB and referring doctor – don’t be embarrassed to ask!
Doesn’t matter if you are on call or not
Best to record a brief note in your EMR
Eg. “Spoke to Dr. X at 1500 on date. Patient with persistent rectal bleeding but stable. Plan: book direct for colonoscopy”

28. Number 1
Don’t forget to bill the age 75+ surcharge - $80.00
This is the number 1 underbilled fee
The list of eligible fees is on the fee guide
Don’t forget you can bill with sigmoidoscopy for volvulus and the “surgical” upper GI fees

29. Number 1

30. The order of the billing matters
Number 1
The order of the billing matters
07001 always has to be in the 2nd slot with the code that is eligible for in the 1st slot Eg
33321 Removal foreign material
07001 Age surcharge 75+
10761 EGD

31. BONUS TIP!!

32. Can keep on top of remittances and resubmissions
Bonus Tip
Do your own billing!
My write-off rate is 0.75%
Typically it is about 5%
That’s $20K for an average income of $400K!
Billing more accurate
Can keep on top of remittances and resubmissions
Familiarize yourself with the fee guide and billing rules

33. Bill for everything that you do
Don’t forget
Bill for everything that you do
Don’t bill for anything that you didn’t do
Document

34. QUESTIONS?

35. Please visit our website to download this presentation