Medicare Compliance & Reimbursement
Compliance:
CMS Identifies Most Egregious Errors in New Compliance Report
Compilation of RAC findings, ZPIC audits, and MAC errors shows you which Part B mistakes y... Read more
CMS Identifies Most Egregious Errors in New Compliance Report
Compilation of RAC findings, ZPIC audits, and MAC errors shows you which Part B mistakes y... Read more
ICD-10:
CMS Is Converting Coverage Decisions to Include ICD-10 Codes
Plus: Medicaid contractors are working to meet ICD-10 deadline. As we reported earlier, CM... Read more
CMS Is Converting Coverage Decisions to Include ICD-10 Codes
Plus: Medicaid contractors are working to meet ICD-10 deadline. As we reported earlier, CM... Read more
Looking Ahead:
What You Can Expect in 2013
Rumors of ICD-10's death have been greatly exaggerated. It isn't even 2012 yet, but the CP... Read more
What You Can Expect in 2013
Rumors of ICD-10's death have been greatly exaggerated. It isn't even 2012 yet, but the CP... Read more
Compliance:
It's The Season For Giving -- But Not Too Much
Keep OIG guidance in mind when deciding on your holiday gift list. With reimbursement chal... Read more
It's The Season For Giving -- But Not Too Much
Keep OIG guidance in mind when deciding on your holiday gift list. With reimbursement chal... Read more
Rural Care:
Protect Your Bottom Line: Implement These Revalidation Letter Requirements
Here's the lowdown on how these CMS changes apply to your practice. If you're a rural hea... Read more
Protect Your Bottom Line: Implement These Revalidation Letter Requirements
Here's the lowdown on how these CMS changes apply to your practice. If you're a rural hea... Read more
Industry Notes
CMS to Cover Obesity Screening and Counseling This holiday season, CMS has given several ... Read more
CMS to Cover Obesity Screening and Counseling This holiday season, CMS has given several ... Read more
Reader Question:
What are the rules for physical presence in a teaching setting?
Question: We are getting a lot of feedback that our emergency physician faculty members, ... Read more
What are the rules for physical presence in a teaching setting?
Question: We are getting a lot of feedback that our emergency physician faculty members, ... Read more
Reader Question:
Submit 95250, Then 95251 for Glucose Monitoring
Question: What is the best way to bill for continuous glucose monitoring? Do we bill for ... Read more
Submit 95250, Then 95251 for Glucose Monitoring
Question: What is the best way to bill for continuous glucose monitoring? Do we bill for ... Read more
Annual Wellness Visits:
2012 Fee Schedule Boosts AWV Pay, Adds 'Health Risk Assessment' Tool Criteria
Look for five percent more in your annual wellness visit RVUs effective Jan. 1. Although y... Read more
2012 Fee Schedule Boosts AWV Pay, Adds 'Health Risk Assessment' Tool Criteria
Look for five percent more in your annual wellness visit RVUs effective Jan. 1. Although y... Read more
Preventive Care:
CMS to Cover Annual Cardiovascular Disease Prevention Visit
Coverage will apply to primary care practitioners, Decision Memo indicates. Amidst growing... Read more
CMS to Cover Annual Cardiovascular Disease Prevention Visit
Coverage will apply to primary care practitioners, Decision Memo indicates. Amidst growing... Read more
Enrollment:
CMS Extends Timeline for Revalidation Effort by Two Years
You can now check the database to determine whether you've been sent a revalidation notic... Read more
CMS Extends Timeline for Revalidation Effort by Two Years
You can now check the database to determine whether you've been sent a revalidation notic... Read more
CPT® 2012:
CPT® Defines 'Other Qualified Healthcare Professional'
Unfortunately, RNs don't make the cut under CPT®'s new definition. If you've wondered wh... Read more
CPT® Defines 'Other Qualified Healthcare Professional'
Unfortunately, RNs don't make the cut under CPT®'s new definition. If you've wondered wh... Read more
Home Health Reimbursement:
Use These 10 Vital Tips for Billing Success
Do your billers' job descriptions really match what they're doing? With your Medicare mar... Read more
Use These 10 Vital Tips for Billing Success
Do your billers' job descriptions really match what they're doing? With your Medicare mar... Read more
Industry Notes
CMS Offers ICD-10 Templates, Planning Assistance The transition for medical practices to ... Read more
CMS Offers ICD-10 Templates, Planning Assistance The transition for medical practices to ... Read more
CMS Further Expands Preventive Care to Cover Depression and Alcohol Misuse Screenings
If alcohol misuse is found, CMS will cover four additional counseling visits. The news tha... Read more
If alcohol misuse is found, CMS will cover four additional counseling visits. The news tha... Read more
Part B Pay:
CMS Slashes 2012 Conversion Factor by Over 27 Percent Vs. Current Rates
Plus: Pay for Radiation oncology, pulmonology, and cardiology will drop even more. Get re... Read more
CMS Slashes 2012 Conversion Factor by Over 27 Percent Vs. Current Rates
Plus: Pay for Radiation oncology, pulmonology, and cardiology will drop even more. Get re... Read more
Compliance:
Part B MACs Now Using 'Predictive Modeling' of Claims to Catch Fraud
Fortunately, software alone won't be responsible for nabbing claim issues. Don't ever acc... Read more
Part B MACs Now Using 'Predictive Modeling' of Claims to Catch Fraud
Fortunately, software alone won't be responsible for nabbing claim issues. Don't ever acc... Read more
Ultrasound Billing:
Probe Carefully to Ethically Maximize Ultrasound Reimbursement
Diagnostic imaging services are under increased payer scrutiny. More and more EDs are us... Read more
Probe Carefully to Ethically Maximize Ultrasound Reimbursement
Diagnostic imaging services are under increased payer scrutiny. More and more EDs are us... Read more
Home Health Reimbursement:
Head Off Doc-Related Denials with These 5 Steps
Get friendly with your physician databases. You won't have any financial recourse if Medi... Read more
Head Off Doc-Related Denials with These 5 Steps
Get friendly with your physician databases. You won't have any financial recourse if Medi... Read more
Industry Notes:
CMS Adds 16 Lab Tests to CLIA-Waived Status
Part B practices will benefit from three new tests that you'll be able to report as "CLIA... Read more
CMS Adds 16 Lab Tests to CLIA-Waived Status
Part B practices will benefit from three new tests that you'll be able to report as "CLIA... Read more
Reader Question:
Collect From Secondary Payer Before Patient
Question: We have many patients with secondary insurance, some of which have deductibles ... Read more
Collect From Secondary Payer Before Patient
Question: We have many patients with secondary insurance, some of which have deductibles ... Read more
Part B Revenue Booster:
4 Steps Keep Your Practice's Reimbursement Flowing
Front desk processes lacking? You could be kissing dollars goodbye. Collecting your due fr... Read more
4 Steps Keep Your Practice's Reimbursement Flowing
Front desk processes lacking? You could be kissing dollars goodbye. Collecting your due fr... Read more
Collections Q&A:
Create a Solid Financial Policy That Tells Your Patients Exactly What You Expect
Get answers to your top financial policy questions from a billing expert. Having a financi... Read more
Create a Solid Financial Policy That Tells Your Patients Exactly What You Expect
Get answers to your top financial policy questions from a billing expert. Having a financi... Read more
Part B Mythbuster:
Same-Day E/M Visit? Modifier 25 May Not Always Be Your Best Bet
Keep E/M documentation apart to demonstrate the service's 'separate' status. When you repo... Read more
Same-Day E/M Visit? Modifier 25 May Not Always Be Your Best Bet
Keep E/M documentation apart to demonstrate the service's 'separate' status. When you repo... Read more
Part B Pay:
MedPAC Recommends Big Cuts to Specialists' Pay
Plus: Under advisory body's latest suggestions, primary care docs would face ten year pay... Read more
MedPAC Recommends Big Cuts to Specialists' Pay
Plus: Under advisory body's latest suggestions, primary care docs would face ten year pay... Read more
Industry Notes:
Report: Some Medicare Fraudsters Are Swiftly Reinstated to the Program
Although you may have heard much buzz about Medicare officials suspending fraudulent provi... Read more
Report: Some Medicare Fraudsters Are Swiftly Reinstated to the Program
Although you may have heard much buzz about Medicare officials suspending fraudulent provi... Read more
Reader Question:
Uncomplicate Complicated Observation, Admit, Discharge Combo Billing
Question: I have trouble figuring out how to charge for a patient that was in observation... Read more
Uncomplicate Complicated Observation, Admit, Discharge Combo Billing
Question: I have trouble figuring out how to charge for a patient that was in observation... Read more
Reader Question:
State Laws Are Paramount When Dealing With Collections
Question: I work in a physician's office handling the collection of past due copays, dedu... Read more
State Laws Are Paramount When Dealing With Collections
Question: I work in a physician's office handling the collection of past due copays, dedu... Read more
Revenue Booster:
Keep Money Flowing With These 6 Income Opportunities
Take the time to ensure that you aren't bleeding revenue in these areas. Just because Medi... Read more
Keep Money Flowing With These 6 Income Opportunities
Take the time to ensure that you aren't bleeding revenue in these areas. Just because Medi... Read more
Compliance:
OIG to Focus on Incident-to Claims, E/M Services, And More in 2012
New OIG Work Plan offers insight into where the agency will be focusing its reviews next y... Read more
OIG to Focus on Incident-to Claims, E/M Services, And More in 2012
New OIG Work Plan offers insight into where the agency will be focusing its reviews next y... Read more
Audits:
RACs Corrected Over $92 Million in Improper Payments Last Year
The good news? Almost $17 million of that went back to doctors who had been underpaid. You... Read more
RACs Corrected Over $92 Million in Improper Payments Last Year
The good news? Almost $17 million of that went back to doctors who had been underpaid. You... Read more
Home Health Enforcement:
Strike Force Takedown Targets 16 Home Care Defendants
Referrals prove a key point of enforcement in this record-breaking sweep. Home care opera... Read more
Strike Force Takedown Targets 16 Home Care Defendants
Referrals prove a key point of enforcement in this record-breaking sweep. Home care opera... Read more
Home Health Reimbursement:
Get Ready To Defend Your LUPA Claims
Appealing LUPA claim denials is costly. If you haven't seen extra scrutiny of your LUPA c... Read more
Get Ready To Defend Your LUPA Claims
Appealing LUPA claim denials is costly. If you haven't seen extra scrutiny of your LUPA c... Read more
Industry Notes:
Tricare HIPAA Breach Could Affect 4.9 Million Patients
Recent spotlights on HIPAA breaches have shown just how many people can be impacted by one... Read more
Tricare HIPAA Breach Could Affect 4.9 Million Patients
Recent spotlights on HIPAA breaches have shown just how many people can be impacted by one... Read more
It's Up To You To Find Out If Your Employees Are Excluded From Medicare
Check and double check your employees for exclusion from federal health care programs. Tha... Read more
Check and double check your employees for exclusion from federal health care programs. Tha... Read more
Compliance:
Could Your Billing Service Be Putting You at A Compliance Risk?
This billing service overcharged Medicare by millions for physicians' charges. You've hire... Read more
Could Your Billing Service Be Putting You at A Compliance Risk?
This billing service overcharged Medicare by millions for physicians' charges. You've hire... Read more
Mac Spotlight:
Enrolled in PECOS Last Year? You'll Still Have to Revalidate, This MAC Says
Practices groaned at the notion that they'll have to track down physicians for more signat... Read more
Enrolled in PECOS Last Year? You'll Still Have to Revalidate, This MAC Says
Practices groaned at the notion that they'll have to track down physicians for more signat... Read more
Workers' Compensation Reimbursement:
5 Guidelines Ease the Pain of Billing Workers' Compensation
If you don't get pertinent information before seeing the patient, expect trouble when you ... Read more
5 Guidelines Ease the Pain of Billing Workers' Compensation
If you don't get pertinent information before seeing the patient, expect trouble when you ... Read more
Part B Payment:
CMS Offers Great News With Fee Schedule Changes
Boost co-surgery, multiple surgery, and bilateral surgery pay for these select procedure... Read more
CMS Offers Great News With Fee Schedule Changes
Boost co-surgery, multiple surgery, and bilateral surgery pay for these select procedure... Read more
Industry Notes:
National HHA Chain Settles Fraud Charges For $150 Million
It's not just Medicare fraud that comes with a big price tag. National chain Maxim Healthc... Read more
National HHA Chain Settles Fraud Charges For $150 Million
It's not just Medicare fraud that comes with a big price tag. National chain Maxim Healthc... Read more
E-Prescribing Penalty:
CMS Finalizes Four New Ways to Avoid 2012 E-Prescribing Payment Penalty
Get your exemption application to CMS no later than Nov. 1 if you want to be considered. H... Read more
CMS Finalizes Four New Ways to Avoid 2012 E-Prescribing Payment Penalty
Get your exemption application to CMS no later than Nov. 1 if you want to be considered. H... Read more
Part B Payment:
CMS Unveils Bundled Payments Initiative
Under the new program, physician's pay for a hospital procedure would be bundled with hosp... Read more
CMS Unveils Bundled Payments Initiative
Under the new program, physician's pay for a hospital procedure would be bundled with hosp... Read more
Reimbursement:
Add These Skills to Your Must-Have List For Billing Managers
3 key skills could make -- or break -- your billing and collections program. Wh... Read more
Add These Skills to Your Must-Have List For Billing Managers
3 key skills could make -- or break -- your billing and collections program. Wh... Read more
Compliance:
Get to the Bottom of the 'Double Dipping' Debate
One MAC goes on record about using the same element twice. The physician has left you copi... Read more
Get to the Bottom of the 'Double Dipping' Debate
One MAC goes on record about using the same element twice. The physician has left you copi... Read more
Home Health Reimbursement:
Medicare Introduces Payment Bundling For Post-Acute Care
The program is voluntary -- for now. CMS has unveiled a payment methodology home car... Read more
Medicare Introduces Payment Bundling For Post-Acute Care
The program is voluntary -- for now. CMS has unveiled a payment methodology home car... Read more
Industry Notes:
CMS Clarifies Whether You'll Report ICD-9 Codes When Dates of Service Span ICD-10 Implementation Date
As most practices know, MACs will no longer accept ICD-9 codes after the Oct. 1, 2013 ICD... Read more
CMS Clarifies Whether You'll Report ICD-9 Codes When Dates of Service Span ICD-10 Implementation Date
As most practices know, MACs will no longer accept ICD-9 codes after the Oct. 1, 2013 ICD... Read more
Reader Question:
Do You Need Two Tax IDs For Traveling Physicians?
Question: We have a dermatologist who wants to partner up with our otolaryngologist one d... Read more
Do You Need Two Tax IDs For Traveling Physicians?
Question: We have a dermatologist who wants to partner up with our otolaryngologist one d... Read more
Reimbursement Roundup:
Uncover Must-Know Appeals Changes Established By New Federal Law
Now's the time to find out how ERISA and PPACA impact your practice -- or you'll face maj... Read more
Uncover Must-Know Appeals Changes Established By New Federal Law
Now's the time to find out how ERISA and PPACA impact your practice -- or you'll face maj... Read more
Follow These New Regulations
In addition to requiring a standardized explanation of benefits (EOB) and allowing the pro... Read more
In addition to requiring a standardized explanation of benefits (EOB) and allowing the pro... Read more
ICD-10 Readiness:
Start Small When Prepping for ICD-10 Conversion, CMS Says
Acquaint yourself with the top 30 diagnoses that your practice sees and you'll get a head... Read more
Start Small When Prepping for ICD-10 Conversion, CMS Says
Acquaint yourself with the top 30 diagnoses that your practice sees and you'll get a head... Read more
E/M Documentation:
Documenting 'All Others Negative' Could Cost Your Physician $87 Per Visit
Ensure that your MAC accepts this commonly-documented phrase before you see your claims do... Read more
Documenting 'All Others Negative' Could Cost Your Physician $87 Per Visit
Ensure that your MAC accepts this commonly-documented phrase before you see your claims do... Read more
Hospice Reimbursement:
Hospice Payment Rates To Increase 2.5% In October
Soon you'll need to make your hospice cap calculation decision. Unlike home health agenci... Read more
Hospice Payment Rates To Increase 2.5% In October
Soon you'll need to make your hospice cap calculation decision. Unlike home health agenci... Read more
Industry Notes:
Chiropractors Aren't Eligible to Order/Refer Services to Medicare Beneficiaries, CMS Says
As if Medicare's ordering/referring guidelines aren't murky enough, CMS has added another ... Read more
Chiropractors Aren't Eligible to Order/Refer Services to Medicare Beneficiaries, CMS Says
As if Medicare's ordering/referring guidelines aren't murky enough, CMS has added another ... Read more
Reader Question:
Skip 99360 When Billing to Medicare
Question: My doctors stand by for surgeons in some high-risk procedures/cases. They want ... Read more
Skip 99360 When Billing to Medicare
Question: My doctors stand by for surgeons in some high-risk procedures/cases. They want ... Read more
Reader Question:
Don't Expect Payment For 'Healthy' Appendectomy
Question: I heard that Medicare will not pay separately for the removal of a healthy appe... Read more
Don't Expect Payment For 'Healthy' Appendectomy
Question: I heard that Medicare will not pay separately for the removal of a healthy appe... Read more
Part B Payment:
Government's Debt Deal Could Hurt Your Medicare Pay
Medicare cuts are on the back burner for now, but will be on the docket if future cuts ar... Read more
Government's Debt Deal Could Hurt Your Medicare Pay
Medicare cuts are on the back burner for now, but will be on the docket if future cuts ar... Read more
On-call Services:
Avoid On-Call Fraud Accusations with These FAQs
Beware: You can't capture ER coverage services with after-hours codes. If you bill incorr... Read more
Avoid On-Call Fraud Accusations with These FAQs
Beware: You can't capture ER coverage services with after-hours codes. If you bill incorr... Read more
Preventive Care:
Don't Look to CMS for AWV Diagnosis Coding Advice
Know what you can legitimately report with annual wellness visit. You can forget about Me... Read more
Don't Look to CMS for AWV Diagnosis Coding Advice
Know what you can legitimately report with annual wellness visit. You can forget about Me... Read more
Revenue Booster:
Say Goodbye to X-Ray Denials With These Simple Tips
Palmetto providers: Add this 'history of' code to the list of covered conditions. If you ... Read more
Say Goodbye to X-Ray Denials With These Simple Tips
Palmetto providers: Add this 'history of' code to the list of covered conditions. If you ... Read more
Home Health Medicaid:
Medicaid F2F Requirement To Hit Next
If your state hasn't adopted a Medicaid face-to-face requirement yet, it will soon. Just w... Read more
Medicaid F2F Requirement To Hit Next
If your state hasn't adopted a Medicaid face-to-face requirement yet, it will soon. Just w... Read more
Home Health Regulations:
Don't Forget That Medicare, Medicaid Are Very Different
Homebound requirements are actually prohibited in Medicaid. In addition to the home healt... Read more
Don't Forget That Medicare, Medicaid Are Very Different
Homebound requirements are actually prohibited in Medicaid. In addition to the home healt... Read more
Industry Notes:
CMS Identifies the 4 Biggest Errors among Therapy Claims
When it comes to Medicare's Comprehensive Error Rate Testing (CERT) reports, the agency te... Read more
CMS Identifies the 4 Biggest Errors among Therapy Claims
When it comes to Medicare's Comprehensive Error Rate Testing (CERT) reports, the agency te... Read more
Part B Mythbuster:
Buying Equipment? Ensure Medicare Reimbursement First
Don't let manufacturers snow you into investing in new gadgets. A neighboring medical pra... Read more
Buying Equipment? Ensure Medicare Reimbursement First
Don't let manufacturers snow you into investing in new gadgets. A neighboring medical pra... Read more
Part B Payment:
Proposed 2012 Fee Schedule Targets Further Cuts to Imaging Interpretations
Next year's conversion factor is set at a dismal $23.9635. As if imaging practices didn't... Read more
Proposed 2012 Fee Schedule Targets Further Cuts to Imaging Interpretations
Next year's conversion factor is set at a dismal $23.9635. As if imaging practices didn't... Read more
Lab Signatures:
Good News: CMS Retracts Lab Signature Requirement
Physician signatures on every lab requisition were perceived as cumbersome, unnecessary. ... Read more
Good News: CMS Retracts Lab Signature Requirement
Physician signatures on every lab requisition were perceived as cumbersome, unnecessary. ... Read more
Medicaid Regulations:
4 Strategies To Stop RACs From Catching You By Surprise
Now's the time to improve your billing and documentation. If recovery audit contractor (R... Read more
4 Strategies To Stop RACs From Catching You By Surprise
Now's the time to improve your billing and documentation. If recovery audit contractor (R... Read more
Home Health PPS:
2012 Cuts To Hit Therapy-Heavy HHAs The Hardest
Proposed cuts are even bigger than CMS says, industry sources maintain. How next year's p... Read more
2012 Cuts To Hit Therapy-Heavy HHAs The Hardest
Proposed cuts are even bigger than CMS says, industry sources maintain. How next year's p... Read more
Industry Notes
MRIs Are Now Billable for Patients with Pacemakers, CMS Says Not all coverage news coming... Read more
MRIs Are Now Billable for Patients with Pacemakers, CMS Says Not all coverage news coming... Read more
Reader Question:
Avoid Outdated Diagnoses
Question: Our practice recently saw a patient who had been having intractable seizures. T... Read more
Avoid Outdated Diagnoses
Question: Our practice recently saw a patient who had been having intractable seizures. T... Read more
Reader Question:
'MIP' and 'MEP' Require Unlisted Diagnoses
Question: How should I bill MIPs (maximum inspiratory pressures) or MEPs (maximum expirat... Read more
'MIP' and 'MEP' Require Unlisted Diagnoses
Question: How should I bill MIPs (maximum inspiratory pressures) or MEPs (maximum expirat... Read more
Compliance:
Unfamiliar With ERISA? Let the Experts Get You Up to Speed With Answers to 5 Top Questions
If you don't learn the ERISA ropes, you could be losing out in the appeal stages. If you d... Read more
Unfamiliar With ERISA? Let the Experts Get You Up to Speed With Answers to 5 Top Questions
If you don't learn the ERISA ropes, you could be losing out in the appeal stages. If you d... Read more
Part B Forms:
You Must Use New ABN by Nov. 1, CMS Says
New form doesn't include major changes, but you are required to switch over to it. It may... Read more
You Must Use New ABN by Nov. 1, CMS Says
New form doesn't include major changes, but you are required to switch over to it. It may... Read more
Reimbursement Roundup:
Don't Overlook Waiver Opportunities -- 3 Steps Ensure Compliance and Patient Payment
Hint: Documented financial hardship is your key. You've heard the mantra over and over&nb... Read more
Don't Overlook Waiver Opportunities -- 3 Steps Ensure Compliance and Patient Payment
Hint: Documented financial hardship is your key. You've heard the mantra over and over&nb... Read more
Home Health Compliance:
Follow These 5 Steps To Protect Against F2F Claims Denials
Are you doing everything you can to boost your face-to-face compliance? It's no longer ju... Read more
Follow These 5 Steps To Protect Against F2F Claims Denials
Are you doing everything you can to boost your face-to-face compliance? It's no longer ju... Read more
Industry Notes:
AMA Report Card Ranks Payers, Finds 19.3 Percent Claims- Processing Error Rate
Physicians received no payment at all on nearly 23 percent of claims submitted to commerci... Read more
AMA Report Card Ranks Payers, Finds 19.3 Percent Claims- Processing Error Rate
Physicians received no payment at all on nearly 23 percent of claims submitted to commerci... Read more
Part B Revenue Booster:
Don't Get Stuck Paying A 15-Percent Penalty If You Know You've Met Incident-to Regs
Follow these tips to ensure you're reporting Incident-to properly. As most Part B practic... Read more
Don't Get Stuck Paying A 15-Percent Penalty If You Know You've Met Incident-to Regs
Follow these tips to ensure you're reporting Incident-to properly. As most Part B practic... Read more
Can You Bill All Services as Incident-to Under One Physician's ID Number?
Incident-to rules apply to the relationship between a physician and a mid-level provider.... Read more
Incident-to rules apply to the relationship between a physician and a mid-level provider.... Read more
Modifiers:
Avoid These 5 Major Modifier Errors to Keep Your Cash Flowing
Reporting modifier 78 for a staged procedure? Expect denials. When it comes to appending ... Read more
Avoid These 5 Major Modifier Errors to Keep Your Cash Flowing
Reporting modifier 78 for a staged procedure? Expect denials. When it comes to appending ... Read more
Correct Coding Initiative:
New Edition of CCI Won't Allow AWV With ECG, E/M, Or Behavior Assessment
Plus: CMS also aims to stop you from billing FNA with excisions, resections, and biopsies... Read more
New Edition of CCI Won't Allow AWV With ECG, E/M, Or Behavior Assessment
Plus: CMS also aims to stop you from billing FNA with excisions, resections, and biopsies... Read more
Part B Coding Coach:
Avoid Giving Care Away for Free During Global With These Quick Tips
Keep modifiers, separate services in mind when offering postoperative care. If you aren't... Read more
Avoid Giving Care Away for Free During Global With These Quick Tips
Keep modifiers, separate services in mind when offering postoperative care. If you aren't... Read more
Industry Notes:
Florida Fraudsters Steal Identity of Legitimate Therapist to Bilk Medicare Out of Thousands
Practitioners may be keeping an eye on their patients' data to ensure that no one steals b... Read more
Florida Fraudsters Steal Identity of Legitimate Therapist to Bilk Medicare Out of Thousands
Practitioners may be keeping an eye on their patients' data to ensure that no one steals b... Read more
Part B Mythbuster:
Get to Know These 3 E/M Myths That Could Be Affecting Your Practice
Hint: Just because your doctor visits the ICU doesn't mean he can report critical care. M... Read more
Get to Know These 3 E/M Myths That Could Be Affecting Your Practice
Hint: Just because your doctor visits the ICU doesn't mean he can report critical care. M... Read more
Modifiers:
Modifier 57 Still Applies to Some Part B Claims, Despite Consult Pay Elimination
Don't ignore modifier 57 just because CMS stopped reimbursing for consults. Medicare may ... Read more
Modifier 57 Still Applies to Some Part B Claims, Despite Consult Pay Elimination
Don't ignore modifier 57 just because CMS stopped reimbursing for consults. Medicare may ... Read more
Part B Payment:
CMS Offers Great News With Fee Schedule Changes
Boost co-surgery, multiple surgery, and bilateral surgery pay for these select procedures... Read more
CMS Offers Great News With Fee Schedule Changes
Boost co-surgery, multiple surgery, and bilateral surgery pay for these select procedures... Read more
EHR Penalties:
CMS Proposes 4 Additional Exemptions to Help You Avoid EHR Penalty
The agency is accepting comments on the proposal through July 25. Hoping to avoid a one p... Read more
CMS Proposes 4 Additional Exemptions to Help You Avoid EHR Penalty
The agency is accepting comments on the proposal through July 25. Hoping to avoid a one p... Read more
Compliance:
Steer Clear Of F2F Violations With Medical Directors
Face-to-face rules may be different for another physician's patients. Do you know when it'... Read more
Steer Clear Of F2F Violations With Medical Directors
Face-to-face rules may be different for another physician's patients. Do you know when it'... Read more
Industry Notes
OIG Recovers $3.4 Billion in First 6 Months of Fiscal Year 2011 Citing a "period of inten... Read more
OIG Recovers $3.4 Billion in First 6 Months of Fiscal Year 2011 Citing a "period of inten... Read more
Compliance:
Are You Considering 'Firing' A Patient? Proceed Carefully to Avoid Getting Burned
These tips will help you avoid legal pitfalls in discharging deadbeat beneficiaries. Deli... Read more
Are You Considering 'Firing' A Patient? Proceed Carefully to Avoid Getting Burned
These tips will help you avoid legal pitfalls in discharging deadbeat beneficiaries. Deli... Read more
E/M Coding:
Answer the $56 Question -- Are You Downcoding Your E/M Visits?
You're not only losing revenue--you're also coding improperly. CMS data from previous yea... Read more
Answer the $56 Question -- Are You Downcoding Your E/M Visits?
You're not only losing revenue--you're also coding improperly. CMS data from previous yea... Read more
Compliance:
Is Your Doctor 'Absent-Minded?' That Excuse Won't Fly With OIG
Auditors have been known to tap into hospitals' wireless hotspots from the parking lot to... Read more
Is Your Doctor 'Absent-Minded?' That Excuse Won't Fly With OIG
Auditors have been known to tap into hospitals' wireless hotspots from the parking lot to... Read more
ICD-10 Preparation:
Not Planning to Transition to ICD-10 as of Oct. 1, 2013? You Might Be Liable to Face Millions in Fines, CMS Reps Say
CMS officials are considering how to handle dates of service that span the pre- and post-... Read more
Not Planning to Transition to ICD-10 as of Oct. 1, 2013? You Might Be Liable to Face Millions in Fines, CMS Reps Say
CMS officials are considering how to handle dates of service that span the pre- and post-... Read more
Medicare Funding:
Medicare Risks Going Broke in 2024, Trustees' Report Says
CMS says it is making changes to ensure the program stays funded longer than projected. Th... Read more
Medicare Risks Going Broke in 2024, Trustees' Report Says
CMS says it is making changes to ensure the program stays funded longer than projected. Th... Read more
Industry Notes
Congress Hears AMA Plea to Consider Physician Payment Reform Congress may have passed a on... Read more
Congress Hears AMA Plea to Consider Physician Payment Reform Congress may have passed a on... Read more
Part B Payment:
5 Mistakes Each Week Could Create $25,000 Revenue Drain
Are you staying on top of claims submissions and appealing when you know you billed prope... Read more
5 Mistakes Each Week Could Create $25,000 Revenue Drain
Are you staying on top of claims submissions and appealing when you know you billed prope... Read more
Part B Coding Coach:
Stop Forfeiting Level Four and Five E/Ms With 3 PMFSH Tips
Make your physician's job easier by letting the patient or nurse document the history. If... Read more
Stop Forfeiting Level Four and Five E/Ms With 3 PMFSH Tips
Make your physician's job easier by letting the patient or nurse document the history. If... Read more
Compliance:
Ward Off Payment Suspensions for 'Credible' Fraud Allegations
Home in on these potential sources of complaints. If your healthcare organization isn't o... Read more
Ward Off Payment Suspensions for 'Credible' Fraud Allegations
Home in on these potential sources of complaints. If your healthcare organization isn't o... Read more
Compliance:
OIG Finds 69 Percent Error Rate in New Outpatient Audit
Avoid these common mistakes so you won't have to refund your MAC. If you're billing an in... Read more
OIG Finds 69 Percent Error Rate in New Outpatient Audit
Avoid these common mistakes so you won't have to refund your MAC. If you're billing an in... Read more
Medicare Claims Errors:
Part B Practices Still Making Modifier, Timely Filing Mistakes, One MAC Says
Don't avoid checking LCDs to find out your MAC's rules. Appending modifier 59 to all of yo... Read more
Part B Practices Still Making Modifier, Timely Filing Mistakes, One MAC Says
Don't avoid checking LCDs to find out your MAC's rules. Appending modifier 59 to all of yo... Read more
Industry Notes
Proving services unrelated to terminal Dx may get harder. It may be wise to beef up your ... Read more
Proving services unrelated to terminal Dx may get harder. It may be wise to beef up your ... Read more
Part B Coding Coach:
Boost Collections With These 4 Quick Tips
If you aren't following up on denials, you're leaving money on the table. The economic do... Read more
Boost Collections With These 4 Quick Tips
If you aren't following up on denials, you're leaving money on the table. The economic do... Read more
Accountable Care Organizations:
CMS Outlines How Joining An ACO Will Benefit Practices, Beneficiaries
Under the "shared savings program," ACO participants will collect a portion of the amount... Read more
CMS Outlines How Joining An ACO Will Benefit Practices, Beneficiaries
Under the "shared savings program," ACO participants will collect a portion of the amount... Read more
Regulations:
Home Care Providers Forge Ahead With F2F Implementation
Newly introduced legislation addresses face-to-face encounter problems. Home care provide... Read more
Home Care Providers Forge Ahead With F2F Implementation
Newly introduced legislation addresses face-to-face encounter problems. Home care provide... Read more
Collections:
Afraid You're Not Getting Paid On Time? Check Out Your State's Prompt Pay Laws
Medicare contractors must pay clean claims within 30 days, but private payers vary. It's ... Read more
Afraid You're Not Getting Paid On Time? Check Out Your State's Prompt Pay Laws
Medicare contractors must pay clean claims within 30 days, but private payers vary. It's ... Read more
Payer Updates:
Skip 96402 For GnRH Injections in Noridian Patients
One MAC OKs RNs/LPNs providing annual wellness visits. If your practice sees patients wit... Read more
Skip 96402 For GnRH Injections in Noridian Patients
One MAC OKs RNs/LPNs providing annual wellness visits. If your practice sees patients wit... Read more
Industry Notes:
CMS Holding Colorectal Cancer Screening and Hepatitis B Vaccine Claims
If some of your Medicare Part B claims are rolling in more slowly than usual, CMS has the... Read more
CMS Holding Colorectal Cancer Screening and Hepatitis B Vaccine Claims
If some of your Medicare Part B claims are rolling in more slowly than usual, CMS has the... Read more
Reader Questions:
Cookie Cutter Appeal Letters Won't Bring in the Cash
Question: After checking to be sure we haven't made a coding or billing entry error, our ... Read more
Cookie Cutter Appeal Letters Won't Bring in the Cash
Question: After checking to be sure we haven't made a coding or billing entry error, our ... Read more
Reader Questions:
Turn to Modifiers 76 or 77 for Repeat Procedure
Note: Modifier 59 won't apply to situations when the physician performs the exact same pr... Read more
Turn to Modifiers 76 or 77 for Repeat Procedure
Note: Modifier 59 won't apply to situations when the physician performs the exact same pr... Read more
Revenue Boosters:
Are You Collecting Every Dollar You Deserve? Avoid Leaving Thousands of Your Dollars in Your MAC's Hands
Hint: Modifiers are key to collecting for screening-turned-diagnostic colonoscopy Could y... Read more
Are You Collecting Every Dollar You Deserve? Avoid Leaving Thousands of Your Dollars in Your MAC's Hands
Hint: Modifiers are key to collecting for screening-turned-diagnostic colonoscopy Could y... Read more
Part B Payments:
Reprocessed Claims From Last Year Are Headed Your Way Soon, CMS Reps Say
The check is in the mail -- really. That's the word from an April 5 CMS Open Door Fo... Read more
Reprocessed Claims From Last Year Are Headed Your Way Soon, CMS Reps Say
The check is in the mail -- really. That's the word from an April 5 CMS Open Door Fo... Read more
HCPCS Codes:
CMS Introduces Several New 'Carrier-Priced' HCPCS Codes
You'll be able to report these codes effective July 1. It's not even mid-2011 yet, but yo... Read more
CMS Introduces Several New 'Carrier-Priced' HCPCS Codes
You'll be able to report these codes effective July 1. It's not even mid-2011 yet, but yo... Read more
Part B Coding Coach:
Converting Laparoscopic Cancer Surgery to Open? Read These Tips Before You Code
This Ob-gyn case study will show you how to properly convert your coding. If your ob-gyn ... Read more
Converting Laparoscopic Cancer Surgery to Open? Read These Tips Before You Code
This Ob-gyn case study will show you how to properly convert your coding. If your ob-gyn ... Read more
Industry Notes:
ICD-9-CM Committee Considers New Diagnoses for Partial Rotator Cuff Tear, Malnutrition, and More
October 1 might sound far away, but the new diagnoses you'll be welcoming at that point a... Read more
ICD-9-CM Committee Considers New Diagnoses for Partial Rotator Cuff Tear, Malnutrition, and More
October 1 might sound far away, but the new diagnoses you'll be welcoming at that point a... Read more
Reader Questions:
'V' Code Can Help You Support Lab Test Claims
Question: Our laboratory received an order for a PSA test for a patient one year after su... Read more
'V' Code Can Help You Support Lab Test Claims
Question: Our laboratory received an order for a PSA test for a patient one year after su... Read more
Reimbursement:
Have You Overlooked These 7 Coding Opportunities?
When your practice is feeling pinched, it’s important to ensure that you aren&rsqu... Read more
Have You Overlooked These 7 Coding Opportunities?
When your practice is feeling pinched, it’s important to ensure that you aren&rsqu... Read more
Correct Coding Initiative:
CCI Now Bars You From Reporting Alcohol and Tobacco Screening Codes With E/M Services
But the good news is that you'll soon be able to report operating microscope code 69990 w... Read more
CCI Now Bars You From Reporting Alcohol and Tobacco Screening Codes With E/M Services
But the good news is that you'll soon be able to report operating microscope code 69990 w... Read more
Part B Mythbuster:
Don't Confuse Facility's Documentation Rules With Surgeon's Report
Concentrate on your physician's thorough note rather than comparing with the facility, ex... Read more
Don't Confuse Facility's Documentation Rules With Surgeon's Report
Concentrate on your physician's thorough note rather than comparing with the facility, ex... Read more
Medicare Error Rates:
Reporting 'Low-Level' 99211? You Still Need Complete Documentation, One MAC Reminds
Just because 99211 is known as a 'nurse visit' doesn't mean you can report it without the... Read more
Reporting 'Low-Level' 99211? You Still Need Complete Documentation, One MAC Reminds
Just because 99211 is known as a 'nurse visit' doesn't mean you can report it without the... Read more
Compliance:
OIG Revisits Recommendation to Adjust Eye Global Surgery Fees
OIG discovered inconsistent billing for global eye surgery and believes adjustments could... Read more
OIG Revisits Recommendation to Adjust Eye Global Surgery Fees
OIG discovered inconsistent billing for global eye surgery and believes adjustments could... Read more
Clip and Save:
Use This Handy Chart to Remember What Equals a Physician Signature
Steer clear of stamps. Learning the ins and outs of what constitutes a compliant handwrit... Read more
Use This Handy Chart to Remember What Equals a Physician Signature
Steer clear of stamps. Learning the ins and outs of what constitutes a compliant handwrit... Read more
INDUSTRY NOTES
CMS resolves vast majority of hotline complaints, OIG report says. As most Part B practic... Read more
CMS resolves vast majority of hotline complaints, OIG report says. As most Part B practic... Read more
In other news
You'll draw CMS's attention if you fail to respond to Comprehensive Error Rate Testing (C... Read more
You'll draw CMS's attention if you fail to respond to Comprehensive Error Rate Testing (C... Read more
Reader Questions:
Know How to Report Nursing Home Visits
Question: How do I bill if our physician went to the nursing home to see Medicare patient... Read more
Know How to Report Nursing Home Visits
Question: How do I bill if our physician went to the nursing home to see Medicare patient... Read more
Reader Questions:
Disease Counseling May Qualify You for Post-Op Pay
Question: We had a breast biopsy patient with a breast cancer diagnosis who had an office... Read more
Disease Counseling May Qualify You for Post-Op Pay
Question: We had a breast biopsy patient with a breast cancer diagnosis who had an office... Read more
Reader Questions:
ABN for Low-Paying Drugs?
Question: As you are probably aware, Pfizer is increasing the cost of Prevnar by $5.00. T... Read more
ABN for Low-Paying Drugs?
Question: As you are probably aware, Pfizer is increasing the cost of Prevnar by $5.00. T... Read more
Compliance:
Beware: 'Audit-Proof' EHRs Don't Exist, Experts Say
The responsibility is on your practice to ensure that you're reporting the right codes. Y... Read more
Beware: 'Audit-Proof' EHRs Don't Exist, Experts Say
The responsibility is on your practice to ensure that you're reporting the right codes. Y... Read more
Documentation:
Do Your Providers Meet Signature Requirements on Their Charts?
Answers to 2 common questions help ensure you're on track. Including provider signatures ... Read more
Do Your Providers Meet Signature Requirements on Their Charts?
Answers to 2 common questions help ensure you're on track. Including provider signatures ... Read more
Medicaid:
RAC 'Bounty Hunters' Turning Their Sights on Medicaid Claims
Fortunately, recent delays give you more time to plan for these audits. If you thought yo... Read more
RAC 'Bounty Hunters' Turning Their Sights on Medicaid Claims
Fortunately, recent delays give you more time to plan for these audits. If you thought yo... Read more
Medicare Part B:
Annual Wellness Visits: G0438-G0439: MACs Share Additional Information About AWVs
Hint: You can perform AWVs on new patients. Part B practices looking for answers about th... Read more
Annual Wellness Visits: G0438-G0439: MACs Share Additional Information About AWVs
Hint: You can perform AWVs on new patients. Part B practices looking for answers about th... Read more
Part B Coding Coach:
Follow These 4 Quick Guidelines to Collect for Inhaler Education Claims
Learn what steps to take when provider charges for a Diskus demo. One thing you should ke... Read more
Follow These 4 Quick Guidelines to Collect for Inhaler Education Claims
Learn what steps to take when provider charges for a Diskus demo. One thing you should ke... Read more
Case Study:
Bringing On an MD + NP Hospitalist Team Proves to Be a Smart Move for This Multi-Provider Organization
The approach reduced rehospitalization and helps position the organization to become an A... Read more
Bringing On an MD + NP Hospitalist Team Proves to Be a Smart Move for This Multi-Provider Organization
The approach reduced rehospitalization and helps position the organization to become an A... Read more
Industry News:
HHS Slaps $1 Million HIPAA Fine On Provider For Lost Data
Warning: HIPAA enforcement is ramping up. The feds don't seem afraid to use their HIPAA fi... Read more
HHS Slaps $1 Million HIPAA Fine On Provider For Lost Data
Warning: HIPAA enforcement is ramping up. The feds don't seem afraid to use their HIPAA fi... Read more
Part B Revenue Booster:
These 5 Tips Will Make Your ASC Coding a Snap
As CMS issues its quarterly ASC payment rates, now's the time to brush up. True or false:... Read more
These 5 Tips Will Make Your ASC Coding a Snap
As CMS issues its quarterly ASC payment rates, now's the time to brush up. True or false:... Read more
Billing:
Know When You Can Write Off a Patient Balance -- and When to Avoid It
You'll end up on the audit radar if you try to skirt the issue. Being a compassionate, ca... Read more
Know When You Can Write Off a Patient Balance -- and When to Avoid It
You'll end up on the audit radar if you try to skirt the issue. Being a compassionate, ca... Read more
ICD-10:
3 Tips Will Get You Closer to ICD-10 Compliance
Hint: You won't always find a simple crosswalk between ICD-9 and ICD-10. When ICD-9 becom... Read more
3 Tips Will Get You Closer to ICD-10 Compliance
Hint: You won't always find a simple crosswalk between ICD-9 and ICD-10. When ICD-9 becom... Read more
Compliance:
Check Out This MAC's Quick Tips on Prepping for Medicare Audits
Accurate documentation will be the most important tool you have in fighting off accusatio... Read more
Check Out This MAC's Quick Tips on Prepping for Medicare Audits
Accurate documentation will be the most important tool you have in fighting off accusatio... Read more
Industry Notes
Part B practices will have 16 new tests that you'll be able to report as "CLIA-waived," t... Read more
Part B practices will have 16 new tests that you'll be able to report as "CLIA-waived," t... Read more
Reader Questions:
Differentiate Between Graft Types
Question: What's the difference between a spinal allograft and an autograft? Answer: If t... Read more
Differentiate Between Graft Types
Question: What's the difference between a spinal allograft and an autograft? Answer: If t... Read more
Reader Questions:
Consider 45990 for Rectal Exam With Anesthesia
Question: I can't seem to find a proper CPT code for this: The surgeon used a bivalve, su... Read more
Consider 45990 for Rectal Exam With Anesthesia
Question: I can't seem to find a proper CPT code for this: The surgeon used a bivalve, su... Read more
Reader Questions:
Stick With Correct Code, Even if Non-covered
Question: Our Medicaid carrier included codes 64470-64476 on the 2009 physician fee sched... Read more
Stick With Correct Code, Even if Non-covered
Question: Our Medicaid carrier included codes 64470-64476 on the 2009 physician fee sched... Read more
Part B Payment:
It's Early in the Year-- And CMS Is Already Changing Its Fee Schedule
The bad news appears to outweigh the good news, unfortunately. When it comes to changing ... Read more
It's Early in the Year-- And CMS Is Already Changing Its Fee Schedule
The bad news appears to outweigh the good news, unfortunately. When it comes to changing ... Read more
Part B Mythbuster:
These 7 Deadly Myths Could Damage Your Practice
Test yourself against these coding and compliance pitfalls. Does your staff subscribe to ... Read more
These 7 Deadly Myths Could Damage Your Practice
Test yourself against these coding and compliance pitfalls. Does your staff subscribe to ... Read more
Incentive Payments:
Want to Show Your Exemption From the E-Prescribing Penalty? Use New G Codes, CMS Says
Three new codes show your MAC why you collect your full pay next year. Never fear: If you ... Read more
Want to Show Your Exemption From the E-Prescribing Penalty? Use New G Codes, CMS Says
Three new codes show your MAC why you collect your full pay next year. Never fear: If you ... Read more
Nursing Facilities:
Boosting E/M Coding Know-How Pays Off for SNFs, Patients, Attendings
Target underbilling in these key scenarios. Skilled nursing facilities looking for new wa... Read more
Boosting E/M Coding Know-How Pays Off for SNFs, Patients, Attendings
Target underbilling in these key scenarios. Skilled nursing facilities looking for new wa... Read more
Reader Questions:
You Can't Choose Not to Bill for Post-Surgical Care
Question: Our practice sees several patients who are on limited incomes. Our physician wo... Read more
You Can't Choose Not to Bill for Post-Surgical Care
Question: Our practice sees several patients who are on limited incomes. Our physician wo... Read more
Reader Questions:
Consider Documentation for Walking Oximetry Payment
Question: Medicare never pays us for walking oximetry. For instance, if we have a visit a... Read more
Consider Documentation for Walking Oximetry Payment
Question: Medicare never pays us for walking oximetry. For instance, if we have a visit a... Read more
Reader Questions:
Know When to Report Hospital Admission Codes
Question: Our physician saw a patient in the office, then admitted her to the hospital la... Read more
Know When to Report Hospital Admission Codes
Question: Our physician saw a patient in the office, then admitted her to the hospital la... Read more
Compliance:
5 Tips Help You Keep Compliance Problems at Bay
How often do you review your compliance plan? In the health care field, it seems like not... Read more
5 Tips Help You Keep Compliance Problems at Bay
How often do you review your compliance plan? In the health care field, it seems like not... Read more
Payment:
Clearly Outline Practice Expectations With No-Show Letters and Fees
Check your payer rules before charging your patients. Every practice has the occasional p... Read more
Clearly Outline Practice Expectations With No-Show Letters and Fees
Check your payer rules before charging your patients. Every practice has the occasional p... Read more
Part B coding Coach:
99214: Tally Review of Systems Accurately and You May Qualify for Higher-Level Codes
Without documentation of each system, prepare to assign a lower code. Medical practices t... Read more
99214: Tally Review of Systems Accurately and You May Qualify for Higher-Level Codes
Without documentation of each system, prepare to assign a lower code. Medical practices t... Read more
Physician Notes:
Missing Physician Signature Could Lead to Unpaid Claims
The old saying, "If it wasn't documented, it wasn't done" has taken on a whole new meaning... Read more
Missing Physician Signature Could Lead to Unpaid Claims
The old saying, "If it wasn't documented, it wasn't done" has taken on a whole new meaning... Read more
Third-Party EHR Registration Will Be Functional By May, CMS Says
If you've been frustrated by the fact that you're essentially barred from registering mult... Read more
If you've been frustrated by the fact that you're essentially barred from registering mult... Read more
Industry News:
CMS Offers Good News and Bad News Regarding Home Oxygen Payment for Cluster Headaches
Plus: Cross These Items Off Your Hospice To-Do List. If you've been battling your carrier... Read more
CMS Offers Good News and Bad News Regarding Home Oxygen Payment for Cluster Headaches
Plus: Cross These Items Off Your Hospice To-Do List. If you've been battling your carrier... Read more
In other news
Hospices have two less things to worry about, thanks to Palmetto GBA's question and answer... Read more
Hospices have two less things to worry about, thanks to Palmetto GBA's question and answer... Read more
Reader Questions:
Keep an Eye on New Modifiers
Question: Thank you for the informative articles on the CPT changes for 2011. We have alr... Read more
Keep an Eye on New Modifiers
Question: Thank you for the informative articles on the CPT changes for 2011. We have alr... Read more
Reader Questions:
You Will Need a Diagnosis Code for a Feigned Illness
Question: Our practice recently had a new patient present with a complaint of severe low ... Read more
You Will Need a Diagnosis Code for a Feigned Illness
Question: Our practice recently had a new patient present with a complaint of severe low ... Read more
Payment:
Medicare Puts Details of Annual Wellness Exams in Writing
Medicare creates new denial codes that will apply when you bill AWV incorrectly. CMS has ... Read more
Medicare Puts Details of Annual Wellness Exams in Writing
Medicare creates new denial codes that will apply when you bill AWV incorrectly. CMS has ... Read more
Trends:
Pumped Up Primary Care May Change Playing Field
There could be more associations between PCPs and specialists, expert predicts. "Primary c... Read more
Pumped Up Primary Care May Change Playing Field
There could be more associations between PCPs and specialists, expert predicts. "Primary c... Read more
Diagnosis Coding:
Most Practices 'Surprised' By How All-Encompassing ICD-10 Transition Has Been
Best bet: Establish your initial plan for conversion immediately so you can project your p... Read more
Most Practices 'Surprised' By How All-Encompassing ICD-10 Transition Has Been
Best bet: Establish your initial plan for conversion immediately so you can project your p... Read more
Tool:
ICD-10 Crosswalks: Never Fear-New Diagnosis Crosswalks Are Here
You'll benefit from the new code set, which includes 2011 diagnoses. In its attempt to ma... Read more
ICD-10 Crosswalks: Never Fear-New Diagnosis Crosswalks Are Here
You'll benefit from the new code set, which includes 2011 diagnoses. In its attempt to ma... Read more
Medicare Billing:
Never Report New Subsequent Observation Codes on the Same Day as Other E/M Code
Plus: CPT clarifies how you should calculate time when using it to pick an E/M code. Effe... Read more
Never Report New Subsequent Observation Codes on the Same Day as Other E/M Code
Plus: CPT clarifies how you should calculate time when using it to pick an E/M code. Effe... Read more
What Do You Think?:
How Would Your Practice Handle This Scenario Involving a Free Med Sample?
Just because you provide a sample as part of care during a visit doesn't mean compliance ... Read more
How Would Your Practice Handle This Scenario Involving a Free Med Sample?
Just because you provide a sample as part of care during a visit doesn't mean compliance ... Read more
Industry News:
MedPAC Calls For 1% Increase to Hospice Payments
Medicare hospice spending has increased 300% over seven years. Hospices would see a 1 per... Read more
MedPAC Calls For 1% Increase to Hospice Payments
Medicare hospice spending has increased 300% over seven years. Hospices would see a 1 per... Read more
Reader Questions:
Patient's Self-Diagnosis May Not Stick
Question: A 48-year-old female, fearing she has H1N1, reports to the emergency department... Read more
Patient's Self-Diagnosis May Not Stick
Question: A 48-year-old female, fearing she has H1N1, reports to the emergency department... Read more
Reader Questions:
Make Sure Diagnoses Are in the Right Order
Question: Many of our ophthalmology patients claim general reasons for their visit, such ... Read more
Make Sure Diagnoses Are in the Right Order
Question: Many of our ophthalmology patients claim general reasons for their visit, such ... Read more
Compliance:
OIG's Semiannual Report Reveals Place-of- Service Coding Errors, Other Issues
Plus: Investigators found one high-utilization county for Medicare therapy dollars. If you... Read more
OIG's Semiannual Report Reveals Place-of- Service Coding Errors, Other Issues
Plus: Investigators found one high-utilization county for Medicare therapy dollars. If you... Read more
Part B Payment:
CMS tweaks 2011 Conversion Factor
Despite adjusted rate of 33.9764, changed RVUs should ensure that your payments will stay... Read more
CMS tweaks 2011 Conversion Factor
Despite adjusted rate of 33.9764, changed RVUs should ensure that your payments will stay... Read more
Physician Notes:
Make These Quick Corrections to CPT 2011
Don't let these items escape your attention. The ink is just barely dry on CPT 2011, but ... Read more
Make These Quick Corrections to CPT 2011
Don't let these items escape your attention. The ink is just barely dry on CPT 2011, but ... Read more
Enrollment:
PECOS Ordering/Referring Edits Won't Start Until July, CMS Says
Six month reprieve gives you extra time to ensure that you're in the system. CMS has offe... Read more
PECOS Ordering/Referring Edits Won't Start Until July, CMS Says
Six month reprieve gives you extra time to ensure that you're in the system. CMS has offe... Read more
PQRI Update:
If You Aren't E-Prescribing in 2011, You'll Face Cuts in Pay in 2012, CMS Says
Get your plan in place ASAP to avoid payment penalties. E-prescribing is technically cons... Read more
If You Aren't E-Prescribing in 2011, You'll Face Cuts in Pay in 2012, CMS Says
Get your plan in place ASAP to avoid payment penalties. E-prescribing is technically cons... Read more
Correct Coding Initiative:
62310 Billed With Arthroscopy? Not Anymore, Thanks to CCI 17.0
New edition of bundling edits target 2011 codes. You may just be digging in to your 2011 ... Read more
62310 Billed With Arthroscopy? Not Anymore, Thanks to CCI 17.0
New edition of bundling edits target 2011 codes. You may just be digging in to your 2011 ... Read more
SNF Reimbursement:
Keep Your Eye on Medicare SNF Part A Fee-For-Service Requirements
Expect the 'practical matter' requirement to be a bigger focus, says expert. Reviewing th... Read more
Keep Your Eye on Medicare SNF Part A Fee-For-Service Requirements
Expect the 'practical matter' requirement to be a bigger focus, says expert. Reviewing th... Read more
Part B Coding Coach:
Modifier 23 Could Apply -- If Your Physician Performed Anesthesia That's 'Unusual'
Knowing enough details about procedure, location can give you the green light. The time o... Read more
Modifier 23 Could Apply -- If Your Physician Performed Anesthesia That's 'Unusual'
Knowing enough details about procedure, location can give you the green light. The time o... Read more
Industry News
The feds continue to see benefits from threatening providers with False Claims Act lawsui... Read more
The feds continue to see benefits from threatening providers with False Claims Act lawsui... Read more