Anesthesia Coding Alert
Claims Reviews Have Begun Again
Question: We’ve been glad to have a break from Medicare claims reviews during the past few months due to the pandemic. When will things be getting back to normal? Oregon Subscriber Answer: According to the July update of its COVID-19 Provider Burden frequently asked questions (FAQs) set, CMS still planned to lift its claims review enforcement discretion in August. “On March 30 CMS suspended most Medicare fee-for-service (FFS) medical review because of the COVID-19 pandemic,” the FAQs reminds. “This included prepayment medical reviews conducted by Medicare Administrative Contractors (MACs) under the Targeted Probe and Educate program, and post-payment reviews conducted by the MACs, Supplemental Medical Review Contractor (SMRC) reviews and Recovery Audit Contractor (RAC).” Now: According to the FAQs, providers should let their MACs know about COVID-19-related issues that might impact responding to reviewers and auditors. Normal standards and regulations will apply to future reviews, CMS indicates; however, the agency does mention that reviewers will take the plethora of flexibilities, waivers, and provisions into account when looking at claims. Check out the FAQs at www.cms.gov/files/document/provider-burden-relief-faqs.pdf.
Anesthesia Coding Alert
- Reimbursement:
Prepare Now for Cuts to Anesthesia and National Conversion Factors
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Follow This Advice to Let Queries Improve Practice Communication
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Choose This for EEG Anesthesia
Question: A patient had an EEG under general anesthesia due to behavioral issues and autism. [...] - Reader Questions:
Include Modifier QS or G8 for MAC Services
Question: One of our providers excised a malignant lesion on the patient’s forearm under general [...] - Reader Questions:
Don’t Submit Modifier 58 for Your Anesthesiologist
Question: Is it appropriate to use modifier 58 on anesthesia encounters when the surgeon plans [...] - Reader Questions:
Verify Specific Pump and Service Before Billing for Refills
Question: I’m having trouble determining the best way to code for programmable pump refills. An [...] - Reader Questions:
Claims Reviews Have Begun Again
Question: We’ve been glad to have a break from Medicare claims reviews during the past [...] - Reader Questions:
Streamline With 1 Labor Epidural Claim, if Possible
Question: We have a labor epidural that has two start and stop times by two [...] - Reader Questions:
Medicare Could Make COVID-19 Code Changes Permanent
Question: Are all these changes to telehealth and other forms of virtual medicine temporary, or [...] - Reader Questions:
Get the Lowdown on NCCI Modifier Indicators
Question: I’m overwhelmed whenever I try to understand the quarterly updates from the National Correct [...]
