Medicare Compliance & Reimbursement
ELECTRONIC PRESCRIPTIONS:
Enter the E-prescribing Era by Following 3 Simple Steps
Find out what percentage bonus you'll receive from Medicare. Can your physician afford no... Read more
Enter the E-prescribing Era by Following 3 Simple Steps
Find out what percentage bonus you'll receive from Medicare. Can your physician afford no... Read more
STRATEGY:
Beware of Buying Equipment Before Ensuring Medicare Reimbursement
Don't let manufacturers snow you into investing in new gadgets. You've heard other office... Read more
Beware of Buying Equipment Before Ensuring Medicare Reimbursement
Don't let manufacturers snow you into investing in new gadgets. You've heard other office... Read more
INDUSTRY NEWS:
Latest on Home Health Fraud Busts
76K for "vacation pay?" Where can we get a gig like that? Recent fraud busts are threaten... Read more
Latest on Home Health Fraud Busts
76K for "vacation pay?" Where can we get a gig like that? Recent fraud busts are threaten... Read more
COLLECTIONS:
Step Up Your Collection Efforts With Credit Cards
But protect patients' credit information to comply with privacy, identity theft rules. Wi... Read more
Step Up Your Collection Efforts With Credit Cards
But protect patients' credit information to comply with privacy, identity theft rules. Wi... Read more
HIPAA SECURITY:
Med Students Need Privacy Training, Caught Posting Unprofessional Messages
Incidents spark crackdown on patient privacy violations. According to the Journal of the ... Read more
Med Students Need Privacy Training, Caught Posting Unprofessional Messages
Incidents spark crackdown on patient privacy violations. According to the Journal of the ... Read more
HIPAA PRIVACY:
Prepare Now For Heightened Privacy and Notification Protections
You're not off the hook if the breach is the vendor's fault. Making the electronic health... Read more
Prepare Now For Heightened Privacy and Notification Protections
You're not off the hook if the breach is the vendor's fault. Making the electronic health... Read more
INDUSTRY NOTES:
OIG Report Cites Care-Plan Related Problems for Nursing Home Hospice Patients
One key strategy can protect your facility's survey record. If a recent OIG report about ... Read more
OIG Report Cites Care-Plan Related Problems for Nursing Home Hospice Patients
One key strategy can protect your facility's survey record. If a recent OIG report about ... Read more
BEWARE:
MICs Can Involve Medicare, Trigger Fraud And Abuse Investigations
4 strategies help you navigate MIC-related payment and compliance woes. If you think the ... Read more
MICs Can Involve Medicare, Trigger Fraud And Abuse Investigations
4 strategies help you navigate MIC-related payment and compliance woes. If you think the ... Read more
HEALTHCARE REFERRALS:
Avoid Holiday Gift-Giving Landmines With These 7 Steps
The recipient of your holiday gift may be your best referral source, but thanking them in... Read more
Avoid Holiday Gift-Giving Landmines With These 7 Steps
The recipient of your holiday gift may be your best referral source, but thanking them in... Read more
Compliance:
Use These 3 General Rules To Master The ABCs Of The MICs
Find out how these auditors work -- and the one way to get on equal footing. Rule No... Read more
Use These 3 General Rules To Master The ABCs Of The MICs
Find out how these auditors work -- and the one way to get on equal footing. Rule No... Read more
COMPLIANCE:
OIG Intends To Home In On Modifier GY Claims, POS Errors, And More In 2010
The OIG's 2010 Work Plan indicates which areas the agency will be reviewing next year, an... Read more
OIG Intends To Home In On Modifier GY Claims, POS Errors, And More In 2010
The OIG's 2010 Work Plan indicates which areas the agency will be reviewing next year, an... Read more
PART B PAYMENT:
2010 Final Rule Simplifies E-Prescribing Process
Extra: CMS will debut a new e-prescribing numerator code. CMS's 2010 Physician Fee Schedu... Read more
2010 Final Rule Simplifies E-Prescribing Process
Extra: CMS will debut a new e-prescribing numerator code. CMS's 2010 Physician Fee Schedu... Read more
PART B PAYMENT:
2010 Fee Schedule Slices Pay For Cardiology, Nuclear Medicine, Audiology, And Other Specialties
But some specialties will benefit from pay boosts. As if a 21.2 percent payment cut was... Read more
2010 Fee Schedule Slices Pay For Cardiology, Nuclear Medicine, Audiology, And Other Specialties
But some specialties will benefit from pay boosts. As if a 21.2 percent payment cut was... Read more
INDUSTRY NEWS:
Former HealthSouth Exec Must Do Time, Appeals Court Says
$41K a day to maintain Scrushy's yacht -- plus other tidbits from the compliance cas... Read more
Former HealthSouth Exec Must Do Time, Appeals Court Says
$41K a day to maintain Scrushy's yacht -- plus other tidbits from the compliance cas... Read more
REIMBURSEMENT:
Watch Out For Claim-Denying Computer Glitches
Don't wait for your MAC to alert you to an error -- be on the lookout for them. If you've... Read more
Watch Out For Claim-Denying Computer Glitches
Don't wait for your MAC to alert you to an error -- be on the lookout for them. If you've... Read more
COMPLIANCE:
Spot Potential Fraud On Your Provider's Claims? Check Documentation, Then Contact Provider
Examine claims for odd activity, experts say. With compliance in the spotlight, many code... Read more
Spot Potential Fraud On Your Provider's Claims? Check Documentation, Then Contact Provider
Examine claims for odd activity, experts say. With compliance in the spotlight, many code... Read more
BILLING:
Give Your MAC Permission To Communicate With Billing Company
Prepare ahead of time by designating the billing company on your enrollment form. Health ... Read more
Give Your MAC Permission To Communicate With Billing Company
Prepare ahead of time by designating the billing company on your enrollment form. Health ... Read more
ELECTRONIC RECORDS:
CMS Begins To Distribute Millions Earmarked For EHRs
Get your electronic health record in place so you can benefit from government bonuses. ... Read more
CMS Begins To Distribute Millions Earmarked For EHRs
Get your electronic health record in place so you can benefit from government bonuses. ... Read more
COMPLIANCE:
Senior Medicare Patrol Recovered $4.5 Million By Watching For Fraud And Abuse
Seniors volunteer for this program, which aims to help the OIG detect issues that might c... Read more
Senior Medicare Patrol Recovered $4.5 Million By Watching For Fraud And Abuse
Seniors volunteer for this program, which aims to help the OIG detect issues that might c... Read more
CLIP 'N' SAVE:
13 Tips For Recouping Payment For Substitute Physicians
Hint: Don't mix up modifiers Q5 and Q6. Although you can't bill locum tenens for new phys... Read more
13 Tips For Recouping Payment For Substitute Physicians
Hint: Don't mix up modifiers Q5 and Q6. Although you can't bill locum tenens for new phys... Read more
CODING COACH:
Stop Forfeiting Up To $779 For Appendectomy Procedures
2 requirements open the door to adding on 44950 to 44970. Do you assume payers will bundl... Read more
Stop Forfeiting Up To $779 For Appendectomy Procedures
2 requirements open the door to adding on 44950 to 44970. Do you assume payers will bundl... Read more
Senator Kaufman Introduces Health Care Fraud Enforcement Act of 2009
Bill would make it easier for prosecutors to link kickback violations with false claims. ... Read more
Bill would make it easier for prosecutors to link kickback violations with false claims. ... Read more
READER QUESTION:
You May Need To Bill Multiple Codes For Trigger Point Injections In The Emergency Department
Remember to document the drug that the physician injected. Question: A patient reported t... Read more
You May Need To Bill Multiple Codes For Trigger Point Injections In The Emergency Department
Remember to document the drug that the physician injected. Question: A patient reported t... Read more
CPT 2010:
New Codes for Cardiac CT, Imaging Debut Jan. 1
Plus: Say goodbye to two perfusion codes. If you've ever wondered whether Medicare actual... Read more
New Codes for Cardiac CT, Imaging Debut Jan. 1
Plus: Say goodbye to two perfusion codes. If you've ever wondered whether Medicare actual... Read more
Beware:
Stark Reg Revamp Impacts Under Arrangement Services
The change is altering the payment and compliance landscape. In the Medicare and Medicaid... Read more
Stark Reg Revamp Impacts Under Arrangement Services
The change is altering the payment and compliance landscape. In the Medicare and Medicaid... Read more
Get a New Lease on Stark Compliance:
Target Variable Compensation Rental Arrangements
If your physician practice or hospital still has these in place, watch out. Trick or trea... Read more
Target Variable Compensation Rental Arrangements
If your physician practice or hospital still has these in place, watch out. Trick or trea... Read more
CPT 2010 Retains Consult Codes, Adds Specificity to Tumor Excision Codes
Plus: Look for new nerve conduction study, facet joint injection codes. Although CMS has ... Read more
Plus: Look for new nerve conduction study, facet joint injection codes. Although CMS has ... Read more
Confused About Trach Tube Changes? 5 Tips Perfect Your Claims
Hint: Whether the fistula tract is established may decide whether code 31502 is warranted... Read more
Hint: Whether the fistula tract is established may decide whether code 31502 is warranted... Read more
INDUSTRY NOTES:
Update Your Billing Address -- Or Lose Your Rights
Plus: Senate lacks votes to change Medicare payment structure, but members vow to keep tr... Read more
Update Your Billing Address -- Or Lose Your Rights
Plus: Senate lacks votes to change Medicare payment structure, but members vow to keep tr... Read more
Better Late Than Sorry with Stark Compliance
Don't delay another day. If you haven't changed your business arrangements to comply with... Read more
Don't delay another day. If you haven't changed your business arrangements to comply with... Read more
COMPLIANCE TRENDS:
Covenant Case Holds Stark Reminders for Hospitals, Physicians
Don't rely overly on the employment exception -- or discount a competitor's ability t... Read more
Covenant Case Holds Stark Reminders for Hospitals, Physicians
Don't rely overly on the employment exception -- or discount a competitor's ability t... Read more
REIMBURSEMENT:
7 Tips Help You Avoid Computer Claim Casualties
Pay attention to EOBs and keep talking to your MAC. You could be losing money to a compute... Read more
7 Tips Help You Avoid Computer Claim Casualties
Pay attention to EOBs and keep talking to your MAC. You could be losing money to a compute... Read more
CODING COACH:
Mark Manipulation to Potentially Recoup $100 or More Per Encounter
No maybes here -- answer this question wrong and you will code your fracture claims i... Read more
Mark Manipulation to Potentially Recoup $100 or More Per Encounter
No maybes here -- answer this question wrong and you will code your fracture claims i... Read more
Compliance Tip:
High Hospital Physician Salaries Can Trigger Anti-Kickback Concerns
Find out what could put you in jeopardy. If you think hospital physician compensation that... Read more
High Hospital Physician Salaries Can Trigger Anti-Kickback Concerns
Find out what could put you in jeopardy. If you think hospital physician compensation that... Read more
BILLING:
CMS Clarifies How to Bill for Skilled Services
But don't expect proposed changes to clear up your confusion. Figuring out which services ... Read more
CMS Clarifies How to Bill for Skilled Services
But don't expect proposed changes to clear up your confusion. Figuring out which services ... Read more
INDUSTRY NOTES:
OIG Finds CMS's CERT Results Inaccurate
Plus: Keep medication units in check with MAC-approved drug calculator tool. Each year, CM... Read more
OIG Finds CMS's CERT Results Inaccurate
Plus: Keep medication units in check with MAC-approved drug calculator tool. Each year, CM... Read more
YOU BE THE CODER
Question: An established patient reported to our practice with a cut in the vestibule of ... Read more
Question: An established patient reported to our practice with a cut in the vestibule of ... Read more
CORRECT CODING INITIATIVE:
Resubmit Previously-Bundled Claims
CCI 15.3 retroactively deletes hundreds of edit pairs,but institutes over 18,000 new bundl... Read more
Resubmit Previously-Bundled Claims
CCI 15.3 retroactively deletes hundreds of edit pairs,but institutes over 18,000 new bundl... Read more
REGULATION:
Create a Policy to Take Back Patients' Unused Controlled Drugs Safely
You can protect family members from drug-related accidents after a patient's death. Scena... Read more
Create a Policy to Take Back Patients' Unused Controlled Drugs Safely
You can protect family members from drug-related accidents after a patient's death. Scena... Read more
E-PRESCRIBING:
3 Tips Help You Transition Easily to E-Prescribing
Don't let your incentive payments fall through the cracks. If your practice is one of the ... Read more
3 Tips Help You Transition Easily to E-Prescribing
Don't let your incentive payments fall through the cracks. If your practice is one of the ... Read more
CODING COACH:
Play the Lesion Excision Waiting Game
Pathology report can unlock $57 more for 11620 if it justifies using the malignancy code. ... Read more
Play the Lesion Excision Waiting Game
Pathology report can unlock $57 more for 11620 if it justifies using the malignancy code. ... Read more
COMPLIANCE:
Watch Date-of-Service on Osteoporosis Claims
Avoid denials with this official guidance. If you're getting denied for osteoporosis drug ... Read more
Watch Date-of-Service on Osteoporosis Claims
Avoid denials with this official guidance. If you're getting denied for osteoporosis drug ... Read more
HIPAA ENFORCEMENT:
Update Patients on Privacy and Security Breaches.
Interim final rule outlines your responsibility for protecting patients' data. You know th... Read more
Update Patients on Privacy and Security Breaches.
Interim final rule outlines your responsibility for protecting patients' data. You know th... Read more
INDUSTRY NOTES:
Wheelchair Suppliers Balk at OIG Report
Plus: Michigan clinic manager pleads guilty to defrauding Medicare of $6.5 million. Suppli... Read more
Wheelchair Suppliers Balk at OIG Report
Plus: Michigan clinic manager pleads guilty to defrauding Medicare of $6.5 million. Suppli... Read more
MEDICARE FORMS:
CMS Wants You to Start Prepping Soon for 5010 Transition
New, standardized reports will show you why your claim was rejected and how to fix it. You... Read more
CMS Wants You to Start Prepping Soon for 5010 Transition
New, standardized reports will show you why your claim was rejected and how to fix it. You... Read more
PAY-FOR-PERFORMANCE:
Quality of Care Gets Financial Incentive Boost
Paying for quality health care pays off, CMS demonstration reveals. The Centers for Medica... Read more
Quality of Care Gets Financial Incentive Boost
Paying for quality health care pays off, CMS demonstration reveals. The Centers for Medica... Read more
HIPAA ENFORCEMENT:
Know the Rules When You Experience a Security Breach
In some cases, you must alert the media. If you violate a patient's privacy, the days wher... Read more
Know the Rules When You Experience a Security Breach
In some cases, you must alert the media. If you violate a patient's privacy, the days wher... Read more
CODING COACH:
Don't Let Age-Related Macular Degeneration Reimbursement Fade Away
Focus on 3 key areas to keep your claims on track. Nearly 2 million Americans have age-rel... Read more
Don't Let Age-Related Macular Degeneration Reimbursement Fade Away
Focus on 3 key areas to keep your claims on track. Nearly 2 million Americans have age-rel... Read more
ICD-9 CODING QUIZ:
Assess Your 2010 Diagnosis Coding Skills.
October 1 is just around the corner, and that means you'll soon need to be up and running... Read more
Assess Your 2010 Diagnosis Coding Skills.
October 1 is just around the corner, and that means you'll soon need to be up and running... Read more
INDUSTRY NOTES:
CMS Says Resubmit 2010 Fee Schedule Comments
Plus: Watch out for in-house identity thieves. If you had an opinion regarding the change... Read more
CMS Says Resubmit 2010 Fee Schedule Comments
Plus: Watch out for in-house identity thieves. If you had an opinion regarding the change... Read more
RAC AUDITS:
RAC Contractors List 7 Audit Issues on Their Radar Screens
Tip: Even if you voluntarily refund improper payments to your MAC, the RAC might still au... Read more
RAC Contractors List 7 Audit Issues on Their Radar Screens
Tip: Even if you voluntarily refund improper payments to your MAC, the RAC might still au... Read more
COLLECTION:
3 Steps Increase Your Collections Success Rate
Improve collections rates and lower write-off amounts with expert advice. With Medicare pa... Read more
3 Steps Increase Your Collections Success Rate
Improve collections rates and lower write-off amounts with expert advice. With Medicare pa... Read more
ASSESSMENT:
5 Tips for Tackling OASIS C Now
Don't let your clinicians off the hook regarding critical thinking. Here are some steps y... Read more
5 Tips for Tackling OASIS C Now
Don't let your clinicians off the hook regarding critical thinking. Here are some steps y... Read more
CODING COACH:
4 Tips Position Your 'Multiple Scope' Codes Perfectly
Here's what you should do when there's no base procedure. If your physician performs sever... Read more
4 Tips Position Your 'Multiple Scope' Codes Perfectly
Here's what you should do when there's no base procedure. If your physician performs sever... Read more
MODIFIERS:
Don't Get Burned by Bilateral Modifier Guidelines
Number '2' in column Z? Strike out modifiers 50, RT, LT as options. Not sure if you can ap... Read more
Don't Get Burned by Bilateral Modifier Guidelines
Number '2' in column Z? Strike out modifiers 50, RT, LT as options. Not sure if you can ap... Read more
INDUSTRY NOTES:
Medicare's Strike Force Comes Down Hard on Dozens of Shady Providers
Plus: HHS no longer provides oversight of HIPAA -- you'll instead look to the Office ... Read more
Medicare's Strike Force Comes Down Hard on Dozens of Shady Providers
Plus: HHS no longer provides oversight of HIPAA -- you'll instead look to the Office ... Read more
REIMBURSEMENT:
Are You Utilizing These Coding Opportunities?
Get your rightful reimbursement for scores of services with these 5 pointers. Medicare... Read more
Are You Utilizing These Coding Opportunities?
Get your rightful reimbursement for scores of services with these 5 pointers. Medicare... Read more
COLLECTION:
Get a Helping Hand From The State to Collect Copays
Analyze these facts before writing off low income copays. If your practice sees a lot of l... Read more
Get a Helping Hand From The State to Collect Copays
Analyze these facts before writing off low income copays. If your practice sees a lot of l... Read more
AUDIT:
RACs to Focus on DME in SNF Stays
Equipment payments for nursing home patients not in Part A stays to get tougher. Medicare ... Read more
RACs to Focus on DME in SNF Stays
Equipment payments for nursing home patients not in Part A stays to get tougher. Medicare ... Read more
CODING COACH:
Bilateral Cochlear Implants Create Programming Code Dilemma
Professional associations go to bat for audiology coders. If your physician performs cochl... Read more
Bilateral Cochlear Implants Create Programming Code Dilemma
Professional associations go to bat for audiology coders. If your physician performs cochl... Read more
HOSPICE:
Will Your Hospice GIP Documentation Stand Up to a Tough Review?
Burnish your documentation skills. Will your hospice general inpatient (GIP) claims pass m... Read more
Will Your Hospice GIP Documentation Stand Up to a Tough Review?
Burnish your documentation skills. Will your hospice general inpatient (GIP) claims pass m... Read more
INDUSTRY NOTES:
Presidential Advisers Predict Strong Growth in Health Employment
Plus: Federal Trade Commission extends the Red Flags Rule until November 1, giving you 3 m... Read more
Presidential Advisers Predict Strong Growth in Health Employment
Plus: Federal Trade Commission extends the Red Flags Rule until November 1, giving you 3 m... Read more
COMPLIANCE:
Ward Off Whistleblower Suits With These 4 Strategies
Cover your bases to head off qui tam suits. You may think you've got all the bases covere... Read more
Ward Off Whistleblower Suits With These 4 Strategies
Cover your bases to head off qui tam suits. You may think you've got all the bases covere... Read more
CODING COACH:
Keep Your Pulmonary Rehab Coding On Course With These 4 FAQs
These Q&A get you up to speed on correct coding and documentation for pulmonary rehab... Read more
Keep Your Pulmonary Rehab Coding On Course With These 4 FAQs
These Q&A get you up to speed on correct coding and documentation for pulmonary rehab... Read more
SELF-AUDIT:
6 Steps Help You Perform a Successful Self-Audit
Use all the resources at your fingertips, including any applicable worksheets that your M... Read more
6 Steps Help You Perform a Successful Self-Audit
Use all the resources at your fingertips, including any applicable worksheets that your M... Read more
OASIS:
Here's The Latest OASIS C Form
Are you ready for these soon-to-be tracked processes? If you've already begun your OASIS ... Read more
Here's The Latest OASIS C Form
Are you ready for these soon-to-be tracked processes? If you've already begun your OASIS ... Read more
INDUSTRY NOTES:
CMS Scraps Timeliness Advice From Recent CMS-855 Transmittal
Plus: Watch out for modifier misuse before it lands you in hot water. When it comes to Me... Read more
CMS Scraps Timeliness Advice From Recent CMS-855 Transmittal
Plus: Watch out for modifier misuse before it lands you in hot water. When it comes to Me... Read more
FEE SCHEDULE:
CMS Proposes Nixing Consult Code Payments
There's more: 21.5 percent cut looms for your services. Heavy pay cuts for your physici... Read more
CMS Proposes Nixing Consult Code Payments
There's more: 21.5 percent cut looms for your services. Heavy pay cuts for your physici... Read more
2010 FEE CHANGES:
Fee Schedule Might Raise IPPE Visit Pay
Watch for changes in e-prescribing eligibility, practice expense RVU development. CMS's... Read more
Fee Schedule Might Raise IPPE Visit Pay
Watch for changes in e-prescribing eligibility, practice expense RVU development. CMS's... Read more
CARRIER SPOTLIGHT:
Electronic PECOS Signatures Won't Be Seen Soon
CMS still wants your certification statements. Medicare carriers are just as eager as you... Read more
Electronic PECOS Signatures Won't Be Seen Soon
CMS still wants your certification statements. Medicare carriers are just as eager as you... Read more
DOCUMENTATION:
Missing Info Will Generate New Remark Code Alert
Check that your claims include the required ordering physician ID number. Starting Oct. 5... Read more
Missing Info Will Generate New Remark Code Alert
Check that your claims include the required ordering physician ID number. Starting Oct. 5... Read more
CODING COACH:
Follow 3 Steps for Pre-Op SPECT Claims Success
Here's why listing V codes first is OK in some situations -- but you'll still need t... Read more
Follow 3 Steps for Pre-Op SPECT Claims Success
Here's why listing V codes first is OK in some situations -- but you'll still need t... Read more
HOME HEALTH:
Double-Check Wheelchair Coding to Avoid Losses
Feds find that suppliers shortchange themselves on standard wheelchairs. You could be los... Read more
Double-Check Wheelchair Coding to Avoid Losses
Feds find that suppliers shortchange themselves on standard wheelchairs. You could be los... Read more
COLLECTIONS:
Get Results for Your Collections Efforts
Let staff use this handy script and leave nothing to chance when collecting. Don't let co... Read more
Get Results for Your Collections Efforts
Let staff use this handy script and leave nothing to chance when collecting. Don't let co... Read more
INDUSTRY NOTES:
Screen Heart Disease Patients Carefully for Depression and Watch for Better Outcomes
Plus: Get ready for revamped Provider Statistical & Reimbursement system. The new dep... Read more
Screen Heart Disease Patients Carefully for Depression and Watch for Better Outcomes
Plus: Get ready for revamped Provider Statistical & Reimbursement system. The new dep... Read more
IN OTHER NEWS ...
IN OTHER NEWS ... Medicare's redesigned Provider Statistical and Reimbursement system is ... Read more
IN OTHER NEWS ... Medicare's redesigned Provider Statistical and Reimbursement system is ... Read more
CCI EDITS:
CCI 15.2 Nixes Edit for Applied Neurostimulator
Check out new edits that affect eye exam codes, anesthesia, and vent management. The Corr... Read more
CCI 15.2 Nixes Edit for Applied Neurostimulator
Check out new edits that affect eye exam codes, anesthesia, and vent management. The Corr... Read more
ENROLLMENT FORMS:
3 Mistakes Could Derail Your Medicare Enrollment
Watch your timing: New transmittal indicates that CMS will immediately return your applic... Read more
3 Mistakes Could Derail Your Medicare Enrollment
Watch your timing: New transmittal indicates that CMS will immediately return your applic... Read more
HIPAA 5010:
2012 Is Coming Soon -- Jump-Start Preparations for the New HIPAA 5010 Form
Contact your software vendor about the form"right away," CMS advises. The feds want you t... Read more
2012 Is Coming Soon -- Jump-Start Preparations for the New HIPAA 5010 Form
Contact your software vendor about the form"right away," CMS advises. The feds want you t... Read more
CODING COACH:
Plan Ahead for New Parallel Upper and Lower Extremity Embolism Coding
Is 'unspecified' your go-to code? If so, you'll need to double-check your choices startin... Read more
Plan Ahead for New Parallel Upper and Lower Extremity Embolism Coding
Is 'unspecified' your go-to code? If so, you'll need to double-check your choices startin... Read more
SUPPLIES:
DME Competitive Bidding Steamrolls Ahead
Medical equipment suppliers must have accreditation, surety bonds to bid. Suppliers wonde... Read more
DME Competitive Bidding Steamrolls Ahead
Medical equipment suppliers must have accreditation, surety bonds to bid. Suppliers wonde... Read more
INDUSTRY NOTES:
Take Note of New Diagnosis Code That Applies to H1N1 Virus (Also Known As 'Swine Flu')
Plus: Watch for new modifier changes in latest CCI edits Practices that are starting to s... Read more
Take Note of New Diagnosis Code That Applies to H1N1 Virus (Also Known As 'Swine Flu')
Plus: Watch for new modifier changes in latest CCI edits Practices that are starting to s... Read more
IN OTHER NEWS ...
CPT continues to add new codes, and the Correct Coding Initiative (CCI) continues to insti... Read more
CPT continues to add new codes, and the Correct Coding Initiative (CCI) continues to insti... Read more
ICD-10 :
CMS Offers Guidance on Guidance on ICD-9 to ICD-10 Crosswalks
Carriers will continue to accept ICD-9 codes 'for a period of time.' Although confusion a... Read more
CMS Offers Guidance on Guidance on ICD-9 to ICD-10 Crosswalks
Carriers will continue to accept ICD-9 codes 'for a period of time.' Although confusion a... Read more
COMPLIANCE :
New Law Tightens Scope of False Claims Act
Mortgage and financial fraud law could crack down on your medical practice. If you've wat... Read more
New Law Tightens Scope of False Claims Act
Mortgage and financial fraud law could crack down on your medical practice. If you've wat... Read more
HOME HEALTH FOCUS :
Catch a Sneak Peek at Your P4P Measures
New patient satisfaction survey has four big flaws, reps point out. You may not have to u... Read more
Catch a Sneak Peek at Your P4P Measures
New patient satisfaction survey has four big flaws, reps point out. You may not have to u... Read more
CODING COACH :
Oncology Focus: Dig Into These Dosimetry Examples and Unlock Payment Potential
Don't miss the one question you must ask your payer. The descriptor for 77300 says it's a... Read more
Oncology Focus: Dig Into These Dosimetry Examples and Unlock Payment Potential
Don't miss the one question you must ask your payer. The descriptor for 77300 says it's a... Read more
APPEALS :
Add Up How Many Low-Dollar Denials You Write Off and Determine Whether to Pursue Payment
The answers may surprise you -- and addressing appeals could add to your bottom line... Read more
Add Up How Many Low-Dollar Denials You Write Off and Determine Whether to Pursue Payment
The answers may surprise you -- and addressing appeals could add to your bottom line... Read more
INDUSTRY NOTES :
CMS Tackles Fraud With New Health Care Fraud Prevention and Enforcement Action Team (HEAT)
Plus: New report shows medical practices spend $85,276 per physician annually to deal wit... Read more
CMS Tackles Fraud With New Health Care Fraud Prevention and Enforcement Action Team (HEAT)
Plus: New report shows medical practices spend $85,276 per physician annually to deal wit... Read more
IN OTHER NEWS ...
• Time is money in a medical practice, and a new study shows just how much money you pu... Read more
• Time is money in a medical practice, and a new study shows just how much money you pu... Read more
ICD-9 CODING :
Get Ready for 141 New ICD-9 Codes Effective Oct. 1
Some of the new codes might even help you prepare for ICD-10. If you've got high hopes th... Read more
Get Ready for 141 New ICD-9 Codes Effective Oct. 1
Some of the new codes might even help you prepare for ICD-10. If you've got high hopes th... Read more
RAC REVIEW :
Train Your Staff to Follow These 6 Tips and Stay a Step Ahead of RACs
Part A is moving toward running out of money -- and Part B could be at risk down the... Read more
Train Your Staff to Follow These 6 Tips and Stay a Step Ahead of RACs
Part A is moving toward running out of money -- and Part B could be at risk down the... Read more
CODING COACH :
Use New Hemorrhoid Destruction Code Correctly or Miss Out on $190
Don't forget the 90-day global period on 46930. If your physician destroys internal hemor... Read more
Use New Hemorrhoid Destruction Code Correctly or Miss Out on $190
Don't forget the 90-day global period on 46930. If your physician destroys internal hemor... Read more
INDUSTRY NOTES :
Verify Diabetic Patient's BMI to Determine Eligibility for Bariatric Weight Loss Surgery
Plus: Senior Medicare Patrol project might be slowing down, but it hasn't disappeared&nbs... Read more
Verify Diabetic Patient's BMI to Determine Eligibility for Bariatric Weight Loss Surgery
Plus: Senior Medicare Patrol project might be slowing down, but it hasn't disappeared&nbs... Read more
IN OTHER NEWS ...
• The Senior Medicare Patrol project may be losing momentum, but it could still cause h... Read more
• The Senior Medicare Patrol project may be losing momentum, but it could still cause h... Read more
MEDICARE FUNDS :
Medicare Trust Fund Risks Going Broke, According to New Report
Part A is moving toward running out of money -- and Part B could be at risk down the... Read more
Medicare Trust Fund Risks Going Broke, According to New Report
Part A is moving toward running out of money -- and Part B could be at risk down the... Read more
RED FLAGS RULE :
CMS Gives More Time to Comply With Red Flags Rule
Deadline extends to August 1, but you'll need that time if you haven't already started. M... Read more
CMS Gives More Time to Comply With Red Flags Rule
Deadline extends to August 1, but you'll need that time if you haven't already started. M... Read more
ICD-10 :
Start Working Toward ICD-10 Transition Now to Be Prepared When the Time Comes
Tip: Know what to expect for your staff training this year. Although Oct. 1, 2013 may see... Read more
Start Working Toward ICD-10 Transition Now to Be Prepared When the Time Comes
Tip: Know what to expect for your staff training this year. Although Oct. 1, 2013 may see... Read more
RAC AUDITS :
Follow These 6 Steps to Prepare for RAC Audits
Take requests for documents seriously and verify that your documentation is solid at all ... Read more
Follow These 6 Steps to Prepare for RAC Audits
Take requests for documents seriously and verify that your documentation is solid at all ... Read more
CODING COACH :
Having a New Epley Code Doesn't Mean You'll Always Get Paid for It
Medicare says 95992 is bundled, denies reimbursement for new code -- here's what it means... Read more
Having a New Epley Code Doesn't Mean You'll Always Get Paid for It
Medicare says 95992 is bundled, denies reimbursement for new code -- here's what it means... Read more
THERAPY :
Don't Forget Caregivers When Trying to Avoid Nursing Home Placement
OT can help your patients stay at home longer. It's no news that occupational therapy can... Read more
Don't Forget Caregivers When Trying to Avoid Nursing Home Placement
OT can help your patients stay at home longer. It's no news that occupational therapy can... Read more
MEDICARE FORMS :
CMS Expects You to Implement New HIPAA 5010 Form by 2012
Heads Up: Start preparing now, because you won't be able to submit ICD-10 codes without i... Read more
CMS Expects You to Implement New HIPAA 5010 Form by 2012
Heads Up: Start preparing now, because you won't be able to submit ICD-10 codes without i... Read more
INDUSTRY NOTES :
OIG Opened 1,750 New Health Care Fraud Investigations During 2008
Plus: OIG investigation finds that eye surgeons collected $97.6 million for E/Ms that the... Read more
OIG Opened 1,750 New Health Care Fraud Investigations During 2008
Plus: OIG investigation finds that eye surgeons collected $97.6 million for E/Ms that the... Read more
IN OTHER NEWS
• As most practices know, E/M services are included in the global packages of most majo... Read more
• As most practices know, E/M services are included in the global packages of most majo... Read more
MEDICARE ERRORS:
Watch Out: E/M Codes Top the List of CERT Mistakes
Physicians documented their subsequent hospital care poorly. If you often rely on 99211, ... Read more
Watch Out: E/M Codes Top the List of CERT Mistakes
Physicians documented their subsequent hospital care poorly. If you often rely on 99211, ... Read more
E/M CODING:
Check Your Answers to These 3 Q&As to Eliminate E/M Coding Confusion
Steer clear of becoming an E/M coding error statistic. If you glean anything from CMS's r... Read more
Check Your Answers to These 3 Q&As to Eliminate E/M Coding Confusion
Steer clear of becoming an E/M coding error statistic. If you glean anything from CMS's r... Read more
HOSPICE:
CMS Proposes Hospice Pay Cuts and More Physician Documentation
Cross your fingers that docs write a compelling essay under new guideline. Hospices that ... Read more
CMS Proposes Hospice Pay Cuts and More Physician Documentation
Cross your fingers that docs write a compelling essay under new guideline. Hospices that ... Read more
CODING COACH:
Stop Catheter Coding Mistakes From Draining Your Reimbursement
Tip: An E/M code might be appropriate for cath removal -- here's how to know. Even i... Read more
Stop Catheter Coding Mistakes From Draining Your Reimbursement
Tip: An E/M code might be appropriate for cath removal -- here's how to know. Even i... Read more
INDUSTRY NOTES:
Off-Kilter Claim Patterns for Inhalation Drugs Set Off OIG's Radar in South Florida
Plus: Another fraud contractor arrives on the scene. If you thought the OIG wasn't lookin... Read more
Off-Kilter Claim Patterns for Inhalation Drugs Set Off OIG's Radar in South Florida
Plus: Another fraud contractor arrives on the scene. If you thought the OIG wasn't lookin... Read more
IN OTHER NEWS ...
•Medicare is nearly halfway finished with naming its new fraud-fighting contractors. Th... Read more
•Medicare is nearly halfway finished with naming its new fraud-fighting contractors. Th... Read more
READER QUESTION:
Follow These Tips to Correctly Report Smoking Cessation Counseling
Caution: Medicare imposes frequency limit on 99406-99407. Question: Do I still need a pla... Read more
Follow These Tips to Correctly Report Smoking Cessation Counseling
Caution: Medicare imposes frequency limit on 99406-99407. Question: Do I still need a pla... Read more
COMPLIANCE:
Texas Hospital Pays Up Over Inflated Outlier Charges
'The consultant told me to' is no defense. If you've increased your charges to potentiall... Read more
Texas Hospital Pays Up Over Inflated Outlier Charges
'The consultant told me to' is no defense. If you've increased your charges to potentiall... Read more
OASIS C:
Kick Off OASIS C Training By Focusing On Positive ADL Changes
You can say goodbye to prior status column for ADLs. The Jan. 1, 2010 start date for usin... Read more
Kick Off OASIS C Training By Focusing On Positive ADL Changes
You can say goodbye to prior status column for ADLs. The Jan. 1, 2010 start date for usin... Read more
PART B REGS:
Signed Certification Statements Are Essential To Your Medicare Enrollment, CMS Says
Plus: CMS clarifies IPPE reimbursement policy. If you're using the PECOS system, your wor... Read more
Signed Certification Statements Are Essential To Your Medicare Enrollment, CMS Says
Plus: CMS clarifies IPPE reimbursement policy. If you're using the PECOS system, your wor... Read more
E/M CODING QUIZ:
Check Your E/M Coding Skills With This Quick Quiz
Do you avoid reporting visits with a patient's family? This advice will help you apply th... Read more
Check Your E/M Coding Skills With This Quick Quiz
Do you avoid reporting visits with a patient's family? This advice will help you apply th... Read more
E/M CODING QUIZ ANSWERS:
How Did You Fare In Testing Your E/M Coding And Billing Skills?
If you answered all three questions correctly, you're a Part B ace. Are your Part B skill... Read more
How Did You Fare In Testing Your E/M Coding And Billing Skills?
If you answered all three questions correctly, you're a Part B ace. Are your Part B skill... Read more
CODING COACH:
5 Answers Capture Suture Removal & Related Work
Tip: Your E/M usually requires 2 components -- which means more than problem-focused... Read more
5 Answers Capture Suture Removal & Related Work
Tip: Your E/M usually requires 2 components -- which means more than problem-focused... Read more
INDUSTRY NOTES:
CMS Care Transition Project Aims To Decrease Hospital Readmissions
Plus: Medicare carriers find quick fix for wrongly rejected physician service claims subm... Read more
CMS Care Transition Project Aims To Decrease Hospital Readmissions
Plus: Medicare carriers find quick fix for wrongly rejected physician service claims subm... Read more
IN OTHER NEWS ...
• Good news for hospices that submit claims with physician services: A claims system fi... Read more
• Good news for hospices that submit claims with physician services: A claims system fi... Read more
RED FLAGS RULE:
No Red Flags Program? You Could Be Losing Thousands
Tip: Institute your Red Flags program ASAP. You may think the government is implementing ... Read more
No Red Flags Program? You Could Be Losing Thousands
Tip: Institute your Red Flags program ASAP. You may think the government is implementing ... Read more
MEDICARE ADVANTAGE :
CMS Overhauls Medicare Advantage Program
Oversight of MA could tighten significantly. CMS is buckling down on the Medicare Advanta... Read more
CMS Overhauls Medicare Advantage Program
Oversight of MA could tighten significantly. CMS is buckling down on the Medicare Advanta... Read more
RED FLAGS RULE :
Act Quickly If Your Practice Identifies a Red Flag
Identity theft is nearly a $50 billion industry. You've implemented a Red Flags program a... Read more
Act Quickly If Your Practice Identifies a Red Flag
Identity theft is nearly a $50 billion industry. You've implemented a Red Flags program a... Read more
BILLING :
Make Sure You Charge For All Your Services
Measure charges and take action, experts say. So you've got a handle on your accounts rec... Read more
Make Sure You Charge For All Your Services
Measure charges and take action, experts say. So you've got a handle on your accounts rec... Read more
DIAGNOSIS CODING :
CMS Dismisses Attachment D Concerns
Sequencing, risk adjustment not harmed by new guidance on secondary diagnosis coding, CMS... Read more
CMS Dismisses Attachment D Concerns
Sequencing, risk adjustment not harmed by new guidance on secondary diagnosis coding, CMS... Read more
PART B REVENUE BOOST :
Brush Up on Your ICD-9 Know-How With These 3 Tips
Confused about fifth digits or V codes? Look no further. Insurers base your reimbursement... Read more
Brush Up on Your ICD-9 Know-How With These 3 Tips
Confused about fifth digits or V codes? Look no further. Insurers base your reimbursement... Read more
CODING COACH :
Keep Chronic Pain Denials at Bay With Surefire Diagnosis Tips
Be careful not to put words in your physician's mouth, or risk audit woes. Imagine your p... Read more
Keep Chronic Pain Denials at Bay With Surefire Diagnosis Tips
Be careful not to put words in your physician's mouth, or risk audit woes. Imagine your p... Read more
INDUSTRY NOTES :
Nevada Radiology Group Gets $2 Million Fine
Plus: One RAC reveals information about how it will evaluate claims during its review pro... Read more
Nevada Radiology Group Gets $2 Million Fine
Plus: One RAC reveals information about how it will evaluate claims during its review pro... Read more
IN OTHER NEWS ...• If your head is spinning with all of the changes between PQRI and e-prescribing, CMS has just the tool for you.
New MLN Matters article MM6394, dated March 20, offers a full breakdown of who is affecte... Read more
New MLN Matters article MM6394, dated March 20, offers a full breakdown of who is affecte... Read more
COMPLIANCE:
Let The OIG Advisory Process Help Your Practice
Tip: Ask before you implement policies. You've most likely read one or two of the OIG's "... Read more
Let The OIG Advisory Process Help Your Practice
Tip: Ask before you implement policies. You've most likely read one or two of the OIG's "... Read more
CORRECT CODING INITIATIVE:
CCI Institutes Over 300,000 New Code Pair Edits
This round, CCI also creates a few welcome deletions. If you thought CCI versions after J... Read more
CCI Institutes Over 300,000 New Code Pair Edits
This round, CCI also creates a few welcome deletions. If you thought CCI versions after J... Read more
BUNDLING:
3 Code Pairs You May Not Want To Report Together
Here's expert advice on reporting your code combinations correctly. The Correct Coding In... Read more
3 Code Pairs You May Not Want To Report Together
Here's expert advice on reporting your code combinations correctly. The Correct Coding In... Read more
OBSERVATION CODING:
Observation Stays Are on the Rise -- 4 Tips Help Code Them
Hint: Roll office visit, observation stay into one code. Physicians are admitting more pa... Read more
Observation Stays Are on the Rise -- 4 Tips Help Code Them
Hint: Roll office visit, observation stay into one code. Physicians are admitting more pa... Read more
PART B MYTHBUSTERS:
Just Because CCI Doesn't 'Bundle' Procedures Doesn't Mean You Can Always Bill Them Together
Even if CCI doesn't publish edits bundling two procedures together, your practice should ... Read more
Just Because CCI Doesn't 'Bundle' Procedures Doesn't Mean You Can Always Bill Them Together
Even if CCI doesn't publish edits bundling two procedures together, your practice should ... Read more
CODING COACH:
Keep Scope Coding 'In The Family' To Avoid Errors
Are you missing out on hundreds? Now's the time to find out. Coding scope procedures, suc... Read more
Keep Scope Coding 'In The Family' To Avoid Errors
Are you missing out on hundreds? Now's the time to find out. Coding scope procedures, suc... Read more
INDUSTRY NOTES:
CMS Corrects 2009 Physician Fee Schedule Final Rule
Plus: One RAC reveals information about how it will evaluate claims during its review pr... Read more
CMS Corrects 2009 Physician Fee Schedule Final Rule
Plus: One RAC reveals information about how it will evaluate claims during its review pr... Read more
IN OTHER NEWS ...• Wondering how the new Recovery Audit Contractors plan to review -- and possibly deny -- your claims from afar?
Now you have part of the answer.The RAC for 17 states, Las Vegas-based HealthDataInsights... Read more
Now you have part of the answer.The RAC for 17 states, Las Vegas-based HealthDataInsights... Read more
READER QUESTION:
Do You Know How to Report Hospital Discharge After Consultation?
Tip: Know which doc attended and which referred to ensure you report patient visits corre... Read more
Do You Know How to Report Hospital Discharge After Consultation?
Tip: Know which doc attended and which referred to ensure you report patient visits corre... Read more
PART B MYTHBUSTER :
These Deadly Myths Could Rob Your Practice
Check your own methods against these coding and billing pitfalls. If you subscribe to any... Read more
These Deadly Myths Could Rob Your Practice
Check your own methods against these coding and billing pitfalls. If you subscribe to any... Read more
BUDGET:
President's Proposed Rate Cuts Threaten HHAs
President's and MedPAC's recommendations are a double whammy. Home health agencies' honey... Read more
President's Proposed Rate Cuts Threaten HHAs
President's and MedPAC's recommendations are a double whammy. Home health agencies' honey... Read more
PQRI:
Make Sure These Errors Don't Cause Your PQRI Bonus To Tank
CMS shows which issues sidelined these practices. Most practices would agree that a 57.2 ... Read more
Make Sure These Errors Don't Cause Your PQRI Bonus To Tank
CMS shows which issues sidelined these practices. Most practices would agree that a 57.2 ... Read more
PATIENT RIGHTS:
Head Off Identity TheftWith This Red Flag Rule Prep
You may need to comply with this surprising requirement by May 1. On May 1, the Federal T... Read more
Head Off Identity TheftWith This Red Flag Rule Prep
You may need to comply with this surprising requirement by May 1. On May 1, the Federal T... Read more
DENIALS:
Make Co-Surgery Denials A Thing Of The Past
4 tips break down what documentation both physicians should have. When two physicians per... Read more
Make Co-Surgery Denials A Thing Of The Past
4 tips break down what documentation both physicians should have. When two physicians per... Read more
CODING COACH:
Consult or Referral? You Be The Judge
Know the 5 Rs to keep the auditors at bay and collect that extra $50 The feds have consul... Read more
Consult or Referral? You Be The Judge
Know the 5 Rs to keep the auditors at bay and collect that extra $50 The feds have consul... Read more
INDUSTRY NOTES:
CMS To Spend More On Physician And Clinical Services In 2009
Plus: Payers may not honor new outpatient therapy cap amount until April, CMS says. If th... Read more
CMS To Spend More On Physician And Clinical Services In 2009
Plus: Payers may not honor new outpatient therapy cap amount until April, CMS says. If th... Read more
PART B REVENUE BOOSTER:
Understand CMS' 30-Day Retrospective Billing Rule
Here's a clarification straight from Medicare. Practices that are panicking over Medicare... Read more
Understand CMS' 30-Day Retrospective Billing Rule
Here's a clarification straight from Medicare. Practices that are panicking over Medicare... Read more
PART B UPDATE:
Stimulus Plan Could Put $44,000 In Doctors' Pockets
Plus: Tighten up your HIPAA policies -- new bill gives government more resources to ... Read more
Stimulus Plan Could Put $44,000 In Doctors' Pockets
Plus: Tighten up your HIPAA policies -- new bill gives government more resources to ... Read more
MODIFIERS:
Clear Up Modifier 79 Confusion
Here's how to report modifier 79 the right way. CMS wants to make it crystal clear: If yo... Read more
Clear Up Modifier 79 Confusion
Here's how to report modifier 79 the right way. CMS wants to make it crystal clear: If yo... Read more
FACET JOINT BILLING:
Physicians Overbilled Facet Joint Injections by $96 Million, OIG Says
CMS warns MACs to be on the lookout for improperly billed injections. Making a $50 error ... Read more
Physicians Overbilled Facet Joint Injections by $96 Million, OIG Says
CMS warns MACs to be on the lookout for improperly billed injections. Making a $50 error ... Read more
COMPLIANCE:
Tackle Your Compliance Questions With 2 FAQs
Would you know how to write an annual report to the OIG? We've got expert tips. Medical p... Read more
Tackle Your Compliance Questions With 2 FAQs
Would you know how to write an annual report to the OIG? We've got expert tips. Medical p... Read more
FRAUD & ABUSE:
Suppliers Take More Heat For Dead Doc Billing
Medicare paid $34 million for claims with faulty doc numbers. Physicians' NPI numbers wil... Read more
Suppliers Take More Heat For Dead Doc Billing
Medicare paid $34 million for claims with faulty doc numbers. Physicians' NPI numbers wil... Read more
CODING COACH:
Affect Your Practice's Bottom Line With Nosebleed Repair Smarts
Coders often under-report their epistaxis claims. If you can't differentiate a complex an... Read more
Affect Your Practice's Bottom Line With Nosebleed Repair Smarts
Coders often under-report their epistaxis claims. If you can't differentiate a complex an... Read more
INDUSTRY NOTES:
Differentiate Traditional Medicare Carriers From the New MACs
Know where to go to find out how long payers in your state are allowed to wait before see... Read more
Differentiate Traditional Medicare Carriers From the New MACs
Know where to go to find out how long payers in your state are allowed to wait before see... Read more
IN OTHER NEWS ...• What to know how to determine the limitations for refund requests in states besides Florida?
Your best bet is to contact your state medical association or society, and they'll have t... Read more
Your best bet is to contact your state medical association or society, and they'll have t... Read more
IN OTHER NEWS ...• The outpatient therapy cap is $1,840
• The outpatient therapy cap is $1,840 for 2009, but the claims system won't reflect th... Read more
• The outpatient therapy cap is $1,840 for 2009, but the claims system won't reflect th... Read more
PART B REVENUE BOOSTER:
Recognize Incident-to Services Or Pay The Price
Hint: Doctor's schedule will be the key. Under incident-to rules, qualified nonphysician ... Read more
Recognize Incident-to Services Or Pay The Price
Hint: Doctor's schedule will be the key. Under incident-to rules, qualified nonphysician ... Read more
CLIP & SAVE:
Let This Tool Make The Incident-To Decisions For You
Follow the flow chart to determine when incident-to services are billable. Suppose your n... Read more
Let This Tool Make The Incident-To Decisions For You
Follow the flow chart to determine when incident-to services are billable. Suppose your n... Read more
COMPLIANCE:
6Ways To Stay Out Of The Compliance Hot Seat
How carefully do you listen to your employees' complaints? Whistleblower lawsuits like th... Read more
6Ways To Stay Out Of The Compliance Hot Seat
How carefully do you listen to your employees' complaints? Whistleblower lawsuits like th... Read more
REIMBURSEMENT:
Understand The Appeals Ropes To Save Your Hard-Earned Reimbursement
Dollars matter the higher in the appeals process you go. Medicare has shaken up its appea... Read more
Understand The Appeals Ropes To Save Your Hard-Earned Reimbursement
Dollars matter the higher in the appeals process you go. Medicare has shaken up its appea... Read more
CODING COACH:
Use These 3 Easy Tips for Headache-Related Nerve Blocks
Correct 64400 and 64405 coding helps ensure payment. If your practice is looking to add b... Read more
Use These 3 Easy Tips for Headache-Related Nerve Blocks
Correct 64400 and 64405 coding helps ensure payment. If your practice is looking to add b... Read more
INDUSTRY NOTES:
Here's Help For Your Modifier JW Rejections
Plus: CMS offers quick primer on billing/coding services performed in ambulatory surgical... Read more
Here's Help For Your Modifier JW Rejections
Plus: CMS offers quick primer on billing/coding services performed in ambulatory surgical... Read more
IN OTHER NEWS ...• Need a quick primer on how to appropriately report your ambulatory surgical center (ASC) services?
CMS provides a lot of information in a new brief fact sheet about ASC billing. The docume... Read more
CMS provides a lot of information in a new brief fact sheet about ASC billing. The docume... Read more
IN OTHER NEWS ...• Suppliers' hopes for significant reform to competitive bidding are hanging on an order from the Obama administration.
As is customary with incoming presidential administrations, White House Chief of Staff Ra... Read more
As is customary with incoming presidential administrations, White House Chief of Staff Ra... Read more
IN OTHER NEWS ...• CMS has extended for three years a demonstration project for disease management of chronically ill,high-cost Medicare beneficiaries.
CMS awarded the extensions to Key to Better Health, a division of Village Health in New Y... Read more
CMS awarded the extensions to Key to Better Health, a division of Village Health in New Y... Read more
READER QUESTION; Differentiate Glaucoma Patient Coding Rules Based on Whether SNF Is Involved
If the patient comes to your practice from a skilled nursing facility, consolidated billi... Read more
If the patient comes to your practice from a skilled nursing facility, consolidated billi... Read more
PART B FUNDING:
Stimulus Bill Earmarks Over $26 Billion for Healthcare
$550 billion bill addresses medical practices. President Barack Obama was just sworn into... Read more
Stimulus Bill Earmarks Over $26 Billion for Healthcare
$550 billion bill addresses medical practices. President Barack Obama was just sworn into... Read more
Prospective Payment System:
MedPAC To Congress: Slash HHA Payments By 10%
The influential advisory body takes agency profit margins to task in its latest recommend... Read more
MedPAC To Congress: Slash HHA Payments By 10%
The influential advisory body takes agency profit margins to task in its latest recommend... Read more
CMS Grants 2 Extra Years To Implement ICD-10
New coding system target date is 2013, according to final rule. If you were concerned abo... Read more
New coding system target date is 2013, according to final rule. If you were concerned abo... Read more
Revenue Booster:
2 Tips Easily Solve Your Code Compliance Errors
Reduce denials for your practice by reading the fine print. There are always a few tricky... Read more
2 Tips Easily Solve Your Code Compliance Errors
Reduce denials for your practice by reading the fine print. There are always a few tricky... Read more
PQRI :
CMS Confirms Incentives, Offers Guidance on PQRI
Plus: CMS offers two reporting periods for PQRI participation. Want to collect your... Read more
CMS Confirms Incentives, Offers Guidance on PQRI
Plus: CMS offers two reporting periods for PQRI participation. Want to collect your... Read more
Credentialing:
CMS Clarifies New 30-Day Retrospective Billing Rule
Count 30 days back from application date, CMS says. CMS has cut its retrospective billing... Read more
CMS Clarifies New 30-Day Retrospective Billing Rule
Count 30 days back from application date, CMS says. CMS has cut its retrospective billing... Read more
Coding Coach:
Steer Your Incident-To Coding Using These 4 Questions
100 percent pay is possible if NPP follows physician's plan of care. If you do not ... Read more
Steer Your Incident-To Coding Using These 4 Questions
100 percent pay is possible if NPP follows physician's plan of care. If you do not ... Read more
Industry Notes:
Stop Stamping Signatures On Your DME Forms
Plus: CMS may expand diagnostic testing coverage for cancer patients' PET scans. If... Read more
Stop Stamping Signatures On Your DME Forms
Plus: CMS may expand diagnostic testing coverage for cancer patients' PET scans. If... Read more
Reader Question:
Do You Know How To Report 2 Polyp Removals Performed At Separate Sessions?
Hint: The answer depends upon whether the physician used the same type of technique... Read more
Do You Know How To Report 2 Polyp Removals Performed At Separate Sessions?
Hint: The answer depends upon whether the physician used the same type of technique... Read more
Correct Coding Initiative:
CCI 15.0 Takes Aim atSeveral New CPT Codes
IV infusion code sees scores of bundles. With more than half a million changes to t... Read more
CCI 15.0 Takes Aim atSeveral New CPT Codes
IV infusion code sees scores of bundles. With more than half a million changes to t... Read more
Part B Billing:
Take "Chase After 'Welcome to Medicare' Exam Deductibles" Off Your To-Do List
Plus: Medicare no longer requires you to perform a screening EKG with the WTM... Read more
Take "Chase After 'Welcome to Medicare' Exam Deductibles" Off Your To-Do List
Plus: Medicare no longer requires you to perform a screening EKG with the WTM... Read more
Accreditation; Sail Through Infection-Prevention Standards
Here's how to dramatically reduce your risk of spreading germs. You and your employees co... Read more
Here's how to dramatically reduce your risk of spreading germs. You and your employees co... Read more
Patient Safety:
Watch Out For Signs Of Elder Abuse Lurking Amongst Your Patients
More than 1 in 10 of those you treat could be suffering. Despite the increase in awarenes... Read more
Watch Out For Signs Of Elder Abuse Lurking Amongst Your Patients
More than 1 in 10 of those you treat could be suffering. Despite the increase in awarenes... Read more
Coding Coach:
Spot E/M Evidence to Gain $130 When Ventilation Management Occurs
These tips help you identify higher paying critical care versus emergency department E/M ... Read more
Spot E/M Evidence to Gain $130 When Ventilation Management Occurs
These tips help you identify higher paying critical care versus emergency department E/M ... Read more
Industry Notes:
CMS Waives 5 Additional Lab Tests
Plus: CMS may expand diagnostic testing coverage for cancer patients' PET scans. Yo... Read more
CMS Waives 5 Additional Lab Tests
Plus: CMS may expand diagnostic testing coverage for cancer patients' PET scans. Yo... Read more
IN OTHER NEWS ...• If you're used to CMS
• If you're used to CMS using its national coverage determination (NCD) process t... Read more
• If you're used to CMS using its national coverage determination (NCD) process t... Read more
IN OTHER NEWS ...• CMS is keeping the heat on
• CMS is keeping the heat on home health agencies in South Florida over abuse of outlie... Read more
• CMS is keeping the heat on home health agencies in South Florida over abuse of outlie... Read more
IN OTHER NEWS ... • You may have a few more hassle
• You may have a few more hassles to deal with as CMS tightens up its enrollment proced... Read more
• You may have a few more hassles to deal with as CMS tightens up its enrollment proced... Read more
Reader Question:
Don't Undercode Condition Checks
Use this advice to determine when MDM puts you on the E/M range. Question: We... Read more
Don't Undercode Condition Checks
Use this advice to determine when MDM puts you on the E/M range. Question: We... Read more