Part B Insider (Multispecialty) Coding Alert
NCCI EDITS:
What CPT 2004 Gives You, NCCI 2004 Takes Away
New codes are hit hard by January NCCI edits They're like shiny new toys that some... Read more
What CPT 2004 Gives You, NCCI 2004 Takes Away
New codes are hit hard by January NCCI edits They're like shiny new toys that some... Read more
DRUG REIMBURSEMENT:
Presence of a Code Doesn't Guarantee Payment
New drug billing can be touch and go The Food & Drug Administration approved Natre... Read more
Presence of a Code Doesn't Guarantee Payment
New drug billing can be touch and go The Food & Drug Administration approved Natre... Read more
ACCOUNT FOR SEASONAL FLUCTUATIONS IN SCHEDULING
Flu season can drive up through the roof the number of patients who absolutely need to see... Read more
Flu season can drive up through the roof the number of patients who absolutely need to see... Read more
NCCI EDITS:
More New and Revised Code Descriptors Changed By NCCI Edits
Cardiotomy, tube placement and infusion painted into a corner by edits Many codes that re... Read more
More New and Revised Code Descriptors Changed By NCCI Edits
Cardiotomy, tube placement and infusion painted into a corner by edits Many codes that re... Read more
DRUG REIMBURSEMENT:
Medicare Cuts 50 Drugs, Raises 49
Chemotherapy drugs are hit harder in reimbursement smackdown Drugs are already being cu... Read more
Medicare Cuts 50 Drugs, Raises 49
Chemotherapy drugs are hit harder in reimbursement smackdown Drugs are already being cu... Read more
SCHEDULING:
Arrive at a Truthful Schedule Before You
Most practices have templates that don't reflect reality So you want to move your practic... Read more
Arrive at a Truthful Schedule Before You
Most practices have templates that don't reflect reality So you want to move your practic... Read more
IV Infusion Bundled Into Lesion Laminectomy Codes
Physician Coder have been accustomed to billing 90780 (Intravenous infusion for therapy/... Read more
Physician Coder have been accustomed to billing 90780 (Intravenous infusion for therapy/... Read more
SCHEDULING:
Adjust Your Capacity to Make Same-Day Scheduling Possible
Seeing today's patients today -it seems like such a simple, beautiful idea. Experts say sa... Read more
Adjust Your Capacity to Make Same-Day Scheduling Possible
Seeing today's patients today -it seems like such a simple, beautiful idea. Experts say sa... Read more
PHYSICIAN NOTES:
AMA Warns of Doctor Glut, Primary-Care Shortage
Delegates vote to change policy to encourage family practice The American Medi... Read more
AMA Warns of Doctor Glut, Primary-Care Shortage
Delegates vote to change policy to encourage family practice The American Medi... Read more
Evaluation:
Resolution to Stop E/M Code Revisions Goes to Trustees
AMA reconsiders 'clinical examples' Evaluation and management codes may not m... Read more
Resolution to Stop E/M Code Revisions Goes to Trustees
AMA reconsiders 'clinical examples' Evaluation and management codes may not m... Read more
History:
Those Who Take a Lousy History Are Condemned to Repent It
4 tips on obtaining a great patient historyIt only takes a few minutes for your physician ... Read more
Those Who Take a Lousy History Are Condemned to Repent It
4 tips on obtaining a great patient historyIt only takes a few minutes for your physician ... Read more
Go Beyond The SOAP Note
When taking a history, many doctors are used to obtaining a simple Subjective Objective As... Read more
When taking a history, many doctors are used to obtaining a simple Subjective Objective As... Read more
History:
Make Sense of a Single Paragraph
Learn to dissect jumbled history into three categoriesMany coders expect the physician to ... Read more
Make Sense of a Single Paragraph
Learn to dissect jumbled history into three categoriesMany coders expect the physician to ... Read more
History:
Don't Use HPI Info to Satisfy ROS
In a recent set of "frequently asked questions," Part B carrier National Heritage Insuranc... Read more
Don't Use HPI Info to Satisfy ROS
In a recent set of "frequently asked questions," Part B carrier National Heritage Insuranc... Read more
Legislation:
Providers Win Regulatory Relief in Medicare Bill
You can correct minor errors without pulling your own teethIf you're drowning in Medicare ... Read more
Providers Win Regulatory Relief in Medicare Bill
You can correct minor errors without pulling your own teethIf you're drowning in Medicare ... Read more
ALJs Move Out of Social Security Administration
Not all of the items passed in the "Regulatory Reform" section of the newly enacted Medica... Read more
Not all of the items passed in the "Regulatory Reform" section of the newly enacted Medica... Read more
Modifiers:
Bill Separately for Decision to Operate
Understand the difference between modifiers -57 and -25Before she picks up a scalpel, the ... Read more
Bill Separately for Decision to Operate
Understand the difference between modifiers -57 and -25Before she picks up a scalpel, the ... Read more
Physician Notes:
Reform Bill Calls for Twice-Yearly ICD-9 Updates
A provision that nobody noticed beforehand sneaked into the Medicare reform bill signed ... Read more
Reform Bill Calls for Twice-Yearly ICD-9 Updates
A provision that nobody noticed beforehand sneaked into the Medicare reform bill signed ... Read more
New Codes:
CPT 2004 Adds Codes for Two Otolaryngology Procedures
Sleep apnea coding won't keep you awake anymoreOtolaryngologists can rejoice - the 2004 up... Read more
CPT 2004 Adds Codes for Two Otolaryngology Procedures
Sleep apnea coding won't keep you awake anymoreOtolaryngologists can rejoice - the 2004 up... Read more
HIPAA:
Carriers, Referral Sources Hoard Billing Information
Misunderstanding HIPAA leads to faulty bills The Health Insurance Portability and Acc... Read more
Carriers, Referral Sources Hoard Billing Information
Misunderstanding HIPAA leads to faulty bills The Health Insurance Portability and Acc... Read more
Payers Follow CMS' Lead In Offering Contingency Plans
With a majority of providers lagging in compliance with the Health Insurance Portability a... Read more
With a majority of providers lagging in compliance with the Health Insurance Portability a... Read more
Venous Access:
New Codes Mean More Specificity But Also More Requirements
Understand the coding requirements for 36555-36597 Coders rejoiced when CPT Codes 200... Read more
New Codes Mean More Specificity But Also More Requirements
Understand the coding requirements for 36555-36597 Coders rejoiced when CPT Codes 200... Read more
CPT Updates:
You Can Bill 20550 per Tendon Sheath Injected
Vaccine delivery codes revised for 2004If your practice bills for multiple tendon sheath i... Read more
You Can Bill 20550 per Tendon Sheath Injected
Vaccine delivery codes revised for 2004If your practice bills for multiple tendon sheath i... Read more
Billing:
What's the Prognosis on Your Diagnostic Billing?
Find out what you can do to get paid for diagnostic tests Billing for diagnostic test... Read more
What's the Prognosis on Your Diagnostic Billing?
Find out what you can do to get paid for diagnostic tests Billing for diagnostic test... Read more
Fraud & Abuse:
Physicians Pay Millions to Settle Allegations
Fraud-busters saved Medicare and other federal healthcare programs $23 billion in 2003, ov... Read more
Physicians Pay Millions to Settle Allegations
Fraud-busters saved Medicare and other federal healthcare programs $23 billion in 2003, ov... Read more
Off-Label Drugs:
Medicare May Cover Unlisted Uses, But Expect to Back Them Up
Drug compendia, studies and documentation all may help gain paymentIf your physician is pr... Read more
Medicare May Cover Unlisted Uses, But Expect to Back Them Up
Drug compendia, studies and documentation all may help gain paymentIf your physician is pr... Read more
Physician Notes:
Medicare Reform Awaits President's Signature
The U.S. Senate approved the most dramatic overhaul of the Medicare program since its in... Read more
Medicare Reform Awaits President's Signature
The U.S. Senate approved the most dramatic overhaul of the Medicare program since its in... Read more
CPT Updates:
Epilepsy Treatments Gain More Specifics in CPT 2004
You have more options to bill for craniotomy or lobectomyIf your physician is performing n... Read more
Epilepsy Treatments Gain More Specifics in CPT 2004
You have more options to bill for craniotomy or lobectomyIf your physician is performing n... Read more
Coding Updates:
Throw Those Modifiers Away for Multiple Transbronchial Biopsies
CPT 2004 also changes code for fluoroscopic guidance If your physician is performing ... Read more
Throw Those Modifiers Away for Multiple Transbronchial Biopsies
CPT 2004 also changes code for fluoroscopic guidance If your physician is performing ... Read more
CPT Adds New Arthrodesis, Corpectomy Codes
The new CPT update also includes some codes for arthrodesis by lateral extracavita... Read more
The new CPT update also includes some codes for arthrodesis by lateral extracavita... Read more
Medicare Reform:
Physicians Escape 4.5 Percent Cut for 2004
Medicare reform legislation will increase payments 1.5 percent in 2004 and 2005 Inst... Read more
Physicians Escape 4.5 Percent Cut for 2004
Medicare reform legislation will increase payments 1.5 percent in 2004 and 2005 Inst... Read more
Drug Cuts:
Oncologists Face Steep Drug Cuts, But Will Practice Expenses Compensate?
Many fear losing out on the swings without gaining enough on the roundabouts.As expected, ... Read more
Oncologists Face Steep Drug Cuts, But Will Practice Expenses Compensate?
Many fear losing out on the swings without gaining enough on the roundabouts.As expected, ... Read more
The States That Benefit Most
According to Sen. Charles Grassley (R-Iowa) and the American Medical Association, here are... Read more
According to Sen. Charles Grassley (R-Iowa) and the American Medical Association, here are... Read more
Medicare Reform:
Medicare Bill Gathers Momentum
AMA, AARP campaigns set to move ball past goal By the time you read this, the Medicar... Read more
Medicare Bill Gathers Momentum
AMA, AARP campaigns set to move ball past goal By the time you read this, the Medicar... Read more
Physician Notes:
Disease Management Comes to Medicare in a Big Way
Program will contract with three organizations to improve chronic diabetes and heart disea... Read more
Disease Management Comes to Medicare in a Big Way
Program will contract with three organizations to improve chronic diabetes and heart disea... Read more
CPT Update:
CPT 2004 Adds Codes for New Techniques and Technologies
Throw away miscellaneous codes for stab phlebectomies, DRILs Medical science marches ... Read more
CPT 2004 Adds Codes for New Techniques and Technologies
Throw away miscellaneous codes for stab phlebectomies, DRILs Medical science marches ... Read more
Local Medical Review Policies:
MAC Ban for Cataract Surgery on Hold - for Now
Prepare to battle more attempts to end 00142 coverageIf your practice performs catar... Read more
MAC Ban for Cataract Surgery on Hold - for Now
Prepare to battle more attempts to end 00142 coverageIf your practice performs catar... Read more
Descriptors Become More Descriptive
The new code for ablation of bone tumors (20982 ) shows a new trend toward more specific c... Read more
The new code for ablation of bone tumors (20982 ) shows a new trend toward more specific c... Read more
Coverage:
CMS Adds Another Annual Screening Test to Arsenal
Get ready to bill for once-a-year iFOBT testsIt's one thing to add a new CPT code for a t... Read more
CMS Adds Another Annual Screening Test to Arsenal
Get ready to bill for once-a-year iFOBT testsIt's one thing to add a new CPT code for a t... Read more
Lesion Excision:
Medicare Gives Providers a Break on Lesion Coding
Malignant lesions will still pay more than benign ones For now, at least, dermatologists ... Read more
Medicare Gives Providers a Break on Lesion Coding
Malignant lesions will still pay more than benign ones For now, at least, dermatologists ... Read more
Coding:
Is a New Era of Coding on the Horizon?
Influential HHS panel to call for abandoning ICD-9-CM The world of medical coding cou... Read more
Is a New Era of Coding on the Horizon?
Influential HHS panel to call for abandoning ICD-9-CM The world of medical coding cou... Read more
Drug Reimbursement:
If Medicare Bill Falls, AWP Rule Will Emerge Quickly
Medicare reform bill appears stalled, negotiators "agree to disagree" If a Medicare presc... Read more
If Medicare Bill Falls, AWP Rule Will Emerge Quickly
Medicare reform bill appears stalled, negotiators "agree to disagree" If a Medicare presc... Read more
Billing:
How to Read an EOB - and Improve Your Billing
5 tips that could save your practice money When you receive an EOB with a payment amo... Read more
How to Read an EOB - and Improve Your Billing
5 tips that could save your practice money When you receive an EOB with a payment amo... Read more
Physician Notes:
Physicians Get a Break on Beneficiary Appeals Documentation
Long-delayed coverage appeal rule at last in final form Burdensome physician certifi... Read more
Physicians Get a Break on Beneficiary Appeals Documentation
Long-delayed coverage appeal rule at last in final form Burdensome physician certifi... Read more
CPT Changes:
New Catheter and Line Placement Codes, New Injection Codes
2004 brings sweeping changes to CPT codes If you know all the important codes in your... Read more
New Catheter and Line Placement Codes, New Injection Codes
2004 brings sweeping changes to CPT codes If you know all the important codes in your... Read more
Reimbursement:
CMS Alters RVUs for Hundreds of Codes
Dermatology and oncology procedures hardest hit despite complaints Not only will all ... Read more
CMS Alters RVUs for Hundreds of Codes
Dermatology and oncology procedures hardest hit despite complaints Not only will all ... Read more
RVU Update:
E/M and Inpatient Visits, Consults Hit Hard by 2004 RVU Changes
Among the dozens of CPT Codes targeted for cutbacks in the 2004 fee schedule are 46 code... Read more
E/M and Inpatient Visits, Consults Hit Hard by 2004 RVU Changes
Among the dozens of CPT Codes targeted for cutbacks in the 2004 fee schedule are 46 code... Read more
Chart:
The Hardest Hit
Some specialties will receive a much bigger knock than the 4.5 percent cut that affects Me... Read more
The Hardest Hit
Some specialties will receive a much bigger knock than the 4.5 percent cut that affects Me... Read more
Laboratory Billing:
Watch Out for Carrier Review of Same-Day Lab/Office Charges
Your laboratory charges could be put under the microscope If your physician sen... Read more
Watch Out for Carrier Review of Same-Day Lab/Office Charges
Your laboratory charges could be put under the microscope If your physician sen... Read more
Top Lab Tests Ordered by Physicians
New statistics released by the Centers for Disease Control and Prevention show those labor... Read more
New statistics released by the Centers for Disease Control and Prevention show those labor... Read more
E/M Visits:
Avoid 'Double-Dipping' for Post-Op E/M Visits
Global period may not apply to nonsurgeons, but ethical standards do If a surgeon han... Read more
Avoid 'Double-Dipping' for Post-Op E/M Visits
Global period may not apply to nonsurgeons, but ethical standards do If a surgeon han... Read more
Physician Notes:
Moving to ICD-10 Codes Could Cost More Than Y2K
A proposed new diagnostic coding system could cost healthcare providers as much as $14 bil... Read more
Moving to ICD-10 Codes Could Cost More Than Y2K
A proposed new diagnostic coding system could cost healthcare providers as much as $14 bil... Read more
CMS Plans to Phase Out Starred Procedures
Get ready to justify modifier -25 for E/M after minor surgeries If your practice perf... Read more
Get ready to justify modifier -25 for E/M after minor surgeries If your practice perf... Read more
Modifiers:
Bill Carefully for 'Co-Managing Surgeons' and Post-Op Transfers
One doctor operates, another follows up: here's how both can get paidWhen one surgeon oper... Read more
Bill Carefully for 'Co-Managing Surgeons' and Post-Op Transfers
One doctor operates, another follows up: here's how both can get paidWhen one surgeon oper... Read more
Know What Code The Surgeon Used
Splitting a surgery using modifiers -54, -55 and -56 requires a lot of coordination, Cobuz... Read more
Splitting a surgery using modifiers -54, -55 and -56 requires a lot of coordination, Cobuz... Read more
Starred Procedures:
Will RVUs Go up for Formerly Starred Procedures?
Consultant predicts new onslaught of audits, scrutiny for modifier -25 Doing away wit... Read more
Will RVUs Go up for Formerly Starred Procedures?
Consultant predicts new onslaught of audits, scrutiny for modifier -25 Doing away wit... Read more
Angiography:
Use CPT Codes, Not G Codes, for Selective Renal/Iliac Angiographies
CMS clarifies long descriptors for G0275 and G0278If your practice bills frequently ... Read more
Use CPT Codes, Not G Codes, for Selective Renal/Iliac Angiographies
CMS clarifies long descriptors for G0275 and G0278If your practice bills frequently ... Read more
Coding:
Don't Bill for Both 43268 and 43269 With ERCP
Stent removal is part of stent change under Medicare You can bill for a number of thin... Read more
Don't Bill for Both 43268 and 43269 With ERCP
Stent removal is part of stent change under Medicare You can bill for a number of thin... Read more
Dermatology:
Code for Multiple Warts Separately, or Throw Away Reimbursement
For multiple billings, know the difference between flat warts and othersIf you're only bil... Read more
Code for Multiple Warts Separately, or Throw Away Reimbursement
For multiple billings, know the difference between flat warts and othersIf you're only bil... Read more
Physician Notes:
CMS Announces Whopping 4.5 Percent Cut to 2004 Physician Spending
Doctors pray for Medicare reform legislation to set it rightForget about that 4.2 percent ... Read more
CMS Announces Whopping 4.5 Percent Cut to 2004 Physician Spending
Doctors pray for Medicare reform legislation to set it rightForget about that 4.2 percent ... Read more
CODING:
Using 44139 Can Add $1,000 to Partial Colectomy Reimbursement
But only if you can decipher the operative report Surgeons who detach the colon from th... Read more
Using 44139 Can Add $1,000 to Partial Colectomy Reimbursement
But only if you can decipher the operative report Surgeons who detach the colon from th... Read more
REIMBURSEMENT TIPS:
Why Do Big-Ticket Procedures Lose Money?
Profitable on paper, but not in reality: know the signs of a money-loser If only counti... Read more
Why Do Big-Ticket Procedures Lose Money?
Profitable on paper, but not in reality: know the signs of a money-loser If only counti... Read more
SURGERY:
How to Read a Colon Surgery Report
Decipher terminology to come up with correct coding for colon procedures When it comes ... Read more
How to Read a Colon Surgery Report
Decipher terminology to come up with correct coding for colon procedures When it comes ... Read more
EXPENSES:
To Keep Physician Expense Data Fresh, CMS Needs A New Approach, Group Says
The Centers for Medicare & Medicaid Services needs to find a new data source to accoun... Read more
To Keep Physician Expense Data Fresh, CMS Needs A New Approach, Group Says
The Centers for Medicare & Medicaid Services needs to find a new data source to accoun... Read more
APPEALS:
Know the Difference Between a Review and a Fair Hearing
Overwhelm carriers with facts and legal background, not emotion So your local carrier h... Read more
Know the Difference Between a Review and a Fair Hearing
Overwhelm carriers with facts and legal background, not emotion So your local carrier h... Read more
Reimbursement:
Don't Forget Geographic Differences, MedPAC Warns
The Agency for Healthcare Research and Quality's Congressionally mandated survey of physic... Read more
Don't Forget Geographic Differences, MedPAC Warns
The Agency for Healthcare Research and Quality's Congressionally mandated survey of physic... Read more
ONCOLOGY DRUGS:
Final Rule Cutting Drug Payments Expected by Nov. 1
CMS takes on board ASCO practice expense survey If your practice dispenses chemotherap... Read more
Final Rule Cutting Drug Payments Expected by Nov. 1
CMS takes on board ASCO practice expense survey If your practice dispenses chemotherap... Read more
PHYSICIAN NOTES:
Medicare Patients Don't Get Benefit of Preventive Care
Patients slip through the cracks, agency states Few beneficiaries are receiving all th... Read more
Medicare Patients Don't Get Benefit of Preventive Care
Patients slip through the cracks, agency states Few beneficiaries are receiving all th... Read more
Coding:
AMA Recommends Changes to E/M Code Descriptors
Association plans 11 questionnaires for specialties The American Medical Association ... Read more
AMA Recommends Changes to E/M Code Descriptors
Association plans 11 questionnaires for specialties The American Medical Association ... Read more
Inpatient Coding:
6 Common Mistakes With Same-Day Observation Admits and Discharges
Are you misusing 99234-99236? Find out hereMost coders understand the basics of handling p... Read more
6 Common Mistakes With Same-Day Observation Admits and Discharges
Are you misusing 99234-99236? Find out hereMost coders understand the basics of handling p... Read more
Points System's Days May Be Numbered
The "points system" for determining evaluation and management may be on its way out, codin... Read more
The "points system" for determining evaluation and management may be on its way out, codin... Read more
Inpatient Shared Visits:
Policy Flip-Flop Leaves Physicians Confused
Shared-visits rule has important differences to incident-to It's been a year sinc... Read more
Policy Flip-Flop Leaves Physicians Confused
Shared-visits rule has important differences to incident-to It's been a year sinc... Read more
CMS Announces VAD Coverage
Medicare will cover ventricular assist devices (VADs) as a destination therapy, the Center... Read more
Medicare will cover ventricular assist devices (VADs) as a destination therapy, the Center... Read more
How to Benchmark Your A/R
Some rules of thumb for knowing when your A/R are out of hand You may know you have a... Read more
Some rules of thumb for knowing when your A/R are out of hand You may know you have a... Read more
Avoid These A/R Pitfalls
Understand what your A/R really means So you've gathered together all your payable... Read more
Understand what your A/R really means So you've gathered together all your payable... Read more
Fraud and Abuse:
Watchdog Barks Out Dirty-Dozen List of Coding Errors
If you're concerned about avoiding the most heinous coding problems, the HHS Office of Ins... Read more
Watchdog Barks Out Dirty-Dozen List of Coding Errors
If you're concerned about avoiding the most heinous coding problems, the HHS Office of Ins... Read more
Physician Notes:
OIG Gives Clean Bill of Health to Physician Claims
The HHS Office of Inspector General may have an ambitious agenda for overlooking physici... Read more
OIG Gives Clean Bill of Health to Physician Claims
The HHS Office of Inspector General may have an ambitious agenda for overlooking physici... Read more
CCI Edits:
Hospital E/M Codes Bundled With Dialysis
99231-99233 and 99261-99263 are components of dialysis For physicians who visit hospi... Read more
Hospital E/M Codes Bundled With Dialysis
99231-99233 and 99261-99263 are components of dialysis For physicians who visit hospi... Read more
Anesthesia:
Know When to Use Modifiers -G8 and -G9 for MAC
As anesthetic and surgical techniques have improved, in many cases it's now no longe... Read more
Know When to Use Modifiers -G8 and -G9 for MAC
As anesthetic and surgical techniques have improved, in many cases it's now no longe... Read more
Understanding -G8, -G9 Modifiers
Although it's unusual to use the -G8 modifier with MAC, you might need it for some s... Read more
Although it's unusual to use the -G8 modifier with MAC, you might need it for some s... Read more
Correct Coding:
Fluoroscopy Codes Come in for More Edits
Bill separately only if nonintegral Your doctor may use fluoroscopic imaging for a nu... Read more
Fluoroscopy Codes Come in for More Edits
Bill separately only if nonintegral Your doctor may use fluoroscopic imaging for a nu... Read more
Coding:
NCCI Edits to Gastrointestinal Surgery are Hard to Stomach
43247 and 43239 especially targetedBilling for surgery on the digestive system just became... Read more
NCCI Edits to Gastrointestinal Surgery are Hard to Stomach
43247 and 43239 especially targetedBilling for surgery on the digestive system just became... Read more
Surgery:
NCCI 9.3 Edits Hit Cardiovascular Surgery Codes Hard
If you've been billing for non-selective catheterization in addition to selective ca... Read more
NCCI 9.3 Edits Hit Cardiovascular Surgery Codes Hard
If you've been billing for non-selective catheterization in addition to selective ca... Read more
Deleted Edits:
Good News for Billing 97750
Physical performance tests no longer bundled If your physician regularly performs physica... Read more
Good News for Billing 97750
Physical performance tests no longer bundled If your physician regularly performs physica... Read more
ANESTHESIA:
NCCI Bundles 64425 Into Most Hernia Repair Codes
Once again, the National Correct Coding Initiative has bundled an anesthesia code into a... Read more
NCCI Bundles 64425 Into Most Hernia Repair Codes
Once again, the National Correct Coding Initiative has bundled an anesthesia code into a... Read more
Physician Notes:
OIG Puts Bull's Eye on ASC Claims
Watch out for audits, scrutiny from carriersIt's like the shockwave before the stampede - ... Read more
OIG Puts Bull's Eye on ASC Claims
Watch out for audits, scrutiny from carriersIt's like the shockwave before the stampede - ... Read more
Use 74150 and 76375 to Bill for Virtual Colonoscopies
CPT editorial panel reputed to be considering new codes Confused about how to code a ... Read more
CPT editorial panel reputed to be considering new codes Confused about how to code a ... Read more
Decubitus Ulcers:
Confused by Ulcer Coding? Here Are Rules to Live By
In real estate, location is always the most important factor. But with decubitus ulcers,... Read more
Confused by Ulcer Coding? Here Are Rules to Live By
In real estate, location is always the most important factor. But with decubitus ulcers,... Read more
Drug Reimbursement:
Confused About J3490 and J9999? Here's the Scoop
Easy tips for billing unlisted drugsHow do you document the need for a drug that doesn't h... Read more
Confused About J3490 and J9999? Here's the Scoop
Easy tips for billing unlisted drugsHow do you document the need for a drug that doesn't h... Read more
CMS Demystifies NCCI - Finally
If you're sick of having to jump through hoops to access the National Correct Coding Initi... Read more
If you're sick of having to jump through hoops to access the National Correct Coding Initi... Read more
Coding:
CMS Updates NCCI Explanation Language
If you're confused about the reasoning behind many National Correct Coding Initiativ... Read more
CMS Updates NCCI Explanation Language
If you're confused about the reasoning behind many National Correct Coding Initiativ... Read more
Don't Bill Two E/M Services in the ER
In the office setting, you can sometimes bill two evaluation and management services on th... Read more
In the office setting, you can sometimes bill two evaluation and management services on th... Read more
Drug Payments:
Medicare Adjusts Dozens of Drug Payments
If your practice bills Medicare for lots of prescription drugs, then it's time to update y... Read more
Medicare Adjusts Dozens of Drug Payments
If your practice bills Medicare for lots of prescription drugs, then it's time to update y... Read more
PHYSICIAN NOTES:
Talk About Copays? No Way!
Physicians don't like to talk about out-of-pocket costs If your doctor doesn'... Read more
Talk About Copays? No Way!
Physicians don't like to talk about out-of-pocket costs If your doctor doesn'... Read more
CMS Threatens 4 Ways for Oncologists to Suffer - Drugs Could Drop 15 Percent per Year
Choose your poison. The Centers for Medicare & Medicaid Services laid out four differe... Read more
Choose your poison. The Centers for Medicare & Medicaid Services laid out four differe... Read more
You Can Override Bundling Edits With 99291 - The Proper Modifiers Can Save Your Life
Life-threatening situations, tough decisions - and bundling edits - all come with critic... Read more
Life-threatening situations, tough decisions - and bundling edits - all come with critic... Read more
Rash of Subpoenas Hits Coders Hard - Managed-Care Plans Seek Coding Nitty-Gritty
Are you now, or have you ever been, an upcoder? That's what the managed-care indus... Read more
Are you now, or have you ever been, an upcoder? That's what the managed-care indus... Read more
Interrupted Colonoscopy Same as Flexible Sigmoidoscopy
If your pathology Coder starts a colonoscopy covered by Medicare but can't finish it... Read more
If your pathology Coder starts a colonoscopy covered by Medicare but can't finish it... Read more
Bill 46621 Along With E/M Services - Avoid Bundling Edits
When your surgeon evaluates a new patient or an established patient with a new problem, ... Read more
When your surgeon evaluates a new patient or an established patient with a new problem, ... Read more
82270 Versus G0107 - Same Test, Different Diagnoses - Understand the Difference Between Screening and Diagnostic
Billing for fecal occult blood tests (82270) became a lot more complicated last year when ... Read more
Billing for fecal occult blood tests (82270) became a lot more complicated last year when ... Read more
CMS Expands Coverage for Lung Surgery
Sometimes the difference between a comma and a dash can mean the world. In a 2001 rule... Read more
Sometimes the difference between a comma and a dash can mean the world. In a 2001 rule... Read more
Upcoding Leads to Boring Weekends - Prosecutors Treat Coding Violations Like Hard-Core Crimes
Enforcers of healthcare-fraud laws are using the latest trends in criminal sentencing to... Read more
Enforcers of healthcare-fraud laws are using the latest trends in criminal sentencing to... Read more
Dozens of Procedures Slashed in 2004 Physician Fee Schedule - 99311, 45385, 99348 Among Hardest Hit
If your physician sees lots of patients in the nursing home or home care settings, y... Read more
If your physician sees lots of patients in the nursing home or home care settings, y... Read more
Billing 93312-93317 As Monitoring Versus Diagnostic - Learn the Difference or Rue Your Reimbursement
Time to start digging back through your files. As of July 1, you can once again receive pa... Read more
Time to start digging back through your files. As of July 1, you can once again receive pa... Read more
COVERED SERVICES
According to a new bulletin from carrier Trailblazer, the diagnostic applications of TEE f... Read more
According to a new bulletin from carrier Trailblazer, the diagnostic applications of TEE f... Read more
Use Counseling to Raise E/M Levels - But Don't Overuse This Technique
Want to bill for a 99214 or 99215 office visit but can't prove the required level of... Read more
Want to bill for a 99214 or 99215 office visit but can't prove the required level of... Read more
Malignant, Benign Lesions:
All the Same to Medicare - New Codes for Home Cardiac Telemetry, ESRD Care
The 2003 CPT book changed the definitions for excision of benign lesions (11400-11446) and... Read more
All the Same to Medicare - New Codes for Home Cardiac Telemetry, ESRD Care
The 2003 CPT book changed the definitions for excision of benign lesions (11400-11446) and... Read more
Malpractice More Important to Your Bottom Line - CMS Ups the Ante
Feeling hit hard by malpractice insurance costs? Medicare feels your pain. Starting n... Read more
Feeling hit hard by malpractice insurance costs? Medicare feels your pain. Starting n... Read more
Minimally Invasive CABG Maximally Noncovered - ButYou Can Bill 33510-33523 for New Techniques
When it comes to new surgical techniques, it's often hard to figure out what Medicare will... Read more
When it comes to new surgical techniques, it's often hard to figure out what Medicare will... Read more
CMS Issues Final 2003 Pricing Update
Even while Medicare was putting forward its massive 2004 fee schedule plan for doctors, it... Read more
Even while Medicare was putting forward its massive 2004 fee schedule plan for doctors, it... Read more
NCCI Bundles 76942 With Dozens of Codes
New Codes Anticipated in 2004 When you're billing for guidance procedures s... Read more
New Codes Anticipated in 2004 When you're billing for guidance procedures s... Read more
Double E/M Spells Triple Headache
Prolonged Services Codes 99354-99357 May Provide Answer Most businesses love same-day... Read more
Prolonged Services Codes 99354-99357 May Provide Answer Most businesses love same-day... Read more
NCCI IS Not Just About Bundling And Mutually Exclusive AnyMore
Don't just think of the National Correct Coding Initiative as a reflection of proced... Read more
Don't just think of the National Correct Coding Initiative as a reflection of proced... Read more
Two Doctors, One Emergency
Who Can Bill 99281-99285? How can you cope with a situation in which one patient saw ... Read more
Who Can Bill 99281-99285? How can you cope with a situation in which one patient saw ... Read more
Know Your ER Modifiers
The key to getting two E/M services paid in the ER is to know your modifiers, Steve Verno ... Read more
The key to getting two E/M services paid in the ER is to know your modifiers, Steve Verno ... Read more
OIG Adds Consults to Injury
3 Easy Ways to Avoid TroubleIf your doctor regularly receives patients from another physic... Read more
3 Easy Ways to Avoid TroubleIf your doctor regularly receives patients from another physic... Read more
If It's a Procedure, It's Not A Consult
If someone sends a patient to your surgeon, who schedules a procedure right away, th... Read more
If someone sends a patient to your surgeon, who schedules a procedure right away, th... Read more
Can You Bill 99211 With Chemotherapy?
Documentation Is the KeyIf a patient comes in for routine chemotherapy and doesn't see the... Read more
Documentation Is the KeyIf a patient comes in for routine chemotherapy and doesn't see the... Read more
Are PIN Deactivations in Store for You?
OIG says pee-yew to the UPIN databaseIf you have a provider identification number you have... Read more
OIG says pee-yew to the UPIN databaseIf you have a provider identification number you have... Read more
Bad Coding for New Devices Hits Physicians in the Wallet
Carriers Plan Massive Take-BacksThe Food and Drug Administration only just approved the fi... Read more
Carriers Plan Massive Take-BacksThe Food and Drug Administration only just approved the fi... Read more
You Can Bill for EUS if You Know Your Codes
Bill Two Biopsies on the Same Day If you're frustrated by new restriction... Read more
Bill Two Biopsies on the Same Day If you're frustrated by new restriction... Read more
CPT Rules Also Hit EUS
It's not just the NCCI edits that restrict billing for other services with EUS. The ... Read more
It's not just the NCCI edits that restrict billing for other services with EUS. The ... Read more
Yes, You CAN Report Electrical Stimulation
Report Using 97032, Not 64565If your physician performs neuromuscular electrical stimulati... Read more
Report Using 97032, Not 64565If your physician performs neuromuscular electrical stimulati... Read more
Differentiate NMES From TENS
When neurologists use a form-fitting garment that delivers NMES electricity directly to ... Read more
When neurologists use a form-fitting garment that delivers NMES electricity directly to ... Read more
Grasp the Difference Between Modifiers -52 and -53
Follow These Strategies for Billing Incomplete Procedures If your physician has to st... Read more
Follow These Strategies for Billing Incomplete Procedures If your physician has to st... Read more
Want To Put In Your Two Cents On Eye Therapy? Here's Your Chance
If your physician uses ocular photodynamic therapy with verteporfin for patients with eye ... Read more
If your physician uses ocular photodynamic therapy with verteporfin for patients with eye ... Read more
Make Sure Your Anesthesiologist Never Oversees More Than Four Patients
Medical Supervision Guidelines Could Decimate Your Reimbursement When it comes to th... Read more
Medical Supervision Guidelines Could Decimate Your Reimbursement When it comes to th... Read more
More ASC Codes Are on the Way
If you were dissatisfied with the procedures that Medicare added to the covered list for a... Read more
If you were dissatisfied with the procedures that Medicare added to the covered list for a... Read more
Reimbursement:
Bill Faster, Send Cleaner Claims
Expert Strategies for Creating a Super Billing Department Your coders are under const... Read more
Bill Faster, Send Cleaner Claims
Expert Strategies for Creating a Super Billing Department Your coders are under const... Read more
Billing Tips:
Spot Common Billing Errors Before They Stain Your Claims
8 Sure-Fire Ways to Prevent Denials Is your practice a denial factory? Here are some ... Read more
Spot Common Billing Errors Before They Stain Your Claims
8 Sure-Fire Ways to Prevent Denials Is your practice a denial factory? Here are some ... Read more
Choose A Medicare 'Quarterback'
Your whole staff should be up to speed on coding and reimbursement issues. But you shoul... Read more
Your whole staff should be up to speed on coding and reimbursement issues. But you shoul... Read more
Care Plan Oversight:
Billing for CPO Requires Careful Planning
Every Minute Counts for Medicare CPO If your practice has lots of patients who go int... Read more
Billing for CPO Requires Careful Planning
Every Minute Counts for Medicare CPO If your practice has lots of patients who go int... Read more
Studies & Surveys:
MedPAC Sees Physician Spending Growth Slowing
Fewer physicians accepted all new Medicare patients in 2002, 70 percent of doctors compare... Read more
MedPAC Sees Physician Spending Growth Slowing
Fewer physicians accepted all new Medicare patients in 2002, 70 percent of doctors compare... Read more
Diagnosis Coding:
Are Your Diagnosis Codes on Autopilot?
Learn to Avoid Denials From Stale ICD-9 Codes You may know your patients inside and o... Read more
Are Your Diagnosis Codes on Autopilot?
Learn to Avoid Denials From Stale ICD-9 Codes You may know your patients inside and o... Read more
Legislation:
Senate Passes Bill to Slash Medical Errors
It may get easier soon for doctors to admit they slipped up.The Senate Health, Education, ... Read more
Senate Passes Bill to Slash Medical Errors
It may get easier soon for doctors to admit they slipped up.The Senate Health, Education, ... Read more
Coverage Corner:
New Policies Target Endoscopy, Angiography
Keeping on top of the latest local medical review policies can spell the difference betwee... Read more
New Policies Target Endoscopy, Angiography
Keeping on top of the latest local medical review policies can spell the difference betwee... Read more
Physicians Notes:
AMA Vows to Bring Back Liability Limits
The recent Senate vote to doom a bill that limits physicians' malpractice to $250,00... Read more
AMA Vows to Bring Back Liability Limits
The recent Senate vote to doom a bill that limits physicians' malpractice to $250,00... Read more
Surgery:
July Brings New ASC Procedures
Learn The Secrets Of Profitable ASC BillingIf your physician provides services in an ambul... Read more
July Brings New ASC Procedures
Learn The Secrets Of Profitable ASC BillingIf your physician provides services in an ambul... Read more
ASC Additions Spell Financial Pain For Physicians
More Medicare Coverage Means Less Money In Some Cases Now that the new list of ambu... Read more
More Medicare Coverage Means Less Money In Some Cases Now that the new list of ambu... Read more
Codes Not Added
Even while industry reps complain Medicare coverage means less money in some instances, th... Read more
Even while industry reps complain Medicare coverage means less money in some instances, th... Read more
Unlisted Code Could Spell Lost Reimbursement
No Extra Pay For Extra Work On Pacemaker Or ICD Sometimes a new code for an added eff... Read more
No Extra Pay For Extra Work On Pacemaker Or ICD Sometimes a new code for an added eff... Read more
No More 14-Day Wait To Bill For Lead Repositioning
Good news: Not only did Medicare add a new code for repositioning a left ventricular lead,... Read more
Good news: Not only did Medicare add a new code for repositioning a left ventricular lead,... Read more
Physicians Could Wait Months To Bill Under New Rule
CMS Imposes Tough Requirements On Enrollment, Say Reps A proposed rule for phys... Read more
CMS Imposes Tough Requirements On Enrollment, Say Reps A proposed rule for phys... Read more
Denial Reasons:
Learn The 10 Deadly Sins Of Claim Submission
Part B carrier AdminaStar Federal recently posted a list of the top ten reasons it denie... Read more
Learn The 10 Deadly Sins Of Claim Submission
Part B carrier AdminaStar Federal recently posted a list of the top ten reasons it denie... Read more
Vaccines Receive Booster Shots For July
CMS Boosts 77 Drugs, Cuts 52 Good news for physicians who dispense drugs: the Centers... Read more
CMS Boosts 77 Drugs, Cuts 52 Good news for physicians who dispense drugs: the Centers... Read more
Medicare Unveils Dozens Of New Remark Codes
Soon when your carrier denies your claim, you'll have more information about why it went d... Read more
Soon when your carrier denies your claim, you'll have more information about why it went d... Read more
Reimbursement:
CMS Backs Off Million-Claim Take-Back Plan
Physicians Won't Have to Pay for Medicare's MistakesJust in time for Independence Day... Read more
CMS Backs Off Million-Claim Take-Back Plan
Physicians Won't Have to Pay for Medicare's MistakesJust in time for Independence Day... Read more
Diagnosis Coding:
SARS and Monkey Pox Codes on the Way
- Hundreds of New ICD-9 Codes in the Works One of the scariest things about a new ep... Read more
SARS and Monkey Pox Codes on the Way
- Hundreds of New ICD-9 Codes in the Works One of the scariest things about a new ep... Read more
Flu Shots Get New ICD-9 Code
Coders may benefit from several new V codes for insulin pump encounters, such as V65.46 ... Read more
Coders may benefit from several new V codes for insulin pump encounters, such as V65.46 ... Read more
Legislation:
Devil Is in Details of Medicare Reform Bills
By the time you read this, the House and Senate negotiators will be up to their necks in w... Read more
Devil Is in Details of Medicare Reform Bills
By the time you read this, the House and Senate negotiators will be up to their necks in w... Read more
Studies & Surveys:
Medicare Should Be a Smart Buyer of Tech
With Medicare facing serious financial constraints, experts say the program needs to find ... Read more
Medicare Should Be a Smart Buyer of Tech
With Medicare facing serious financial constraints, experts say the program needs to find ... Read more
Coding:
When Routine Ob-Gyn Screenings Turn Up Problems
Use These Strategies to Avoid Double-Billing, UpcodingWhen a patient comes in for a routin... Read more
When Routine Ob-Gyn Screenings Turn Up Problems
Use These Strategies to Avoid Double-Billing, UpcodingWhen a patient comes in for a routin... Read more
Coverage:
CMS Announces 4 New Coverage Actions
CMS Announces 4 New Coverage Actions The Centers for Medicare & Medicaid Services ... Read more
CMS Announces 4 New Coverage Actions
CMS Announces 4 New Coverage Actions The Centers for Medicare & Medicaid Services ... Read more
Legislation:
Medicare Reform Bills Spell Pain for Physicians
It's not all goodies in the Medicare reform bills passed by the House and the Senate... Read more
Medicare Reform Bills Spell Pain for Physicians
It's not all goodies in the Medicare reform bills passed by the House and the Senate... Read more
Physician Notes:
Vital Physician Info Goes Online
CMS Broadcast Will Cover Medicare Rules on New PatientsMore information on more physicians... Read more
Vital Physician Info Goes Online
CMS Broadcast Will Cover Medicare Rules on New PatientsMore information on more physicians... Read more
Coding:
Anesthesiologists Will Feel Pain From NCCI
If you're billing for anesthetic injection services with dozens of surgery codes, you can ... Read more
Anesthesiologists Will Feel Pain From NCCI
If you're billing for anesthetic injection services with dozens of surgery codes, you can ... Read more
CMS:
Physicians Brace for New Provider Enrollment Reg
The Centers for Medicare & Medicaid Services' new provider enrollment regulation will ... Read more
Physicians Brace for New Provider Enrollment Reg
The Centers for Medicare & Medicaid Services' new provider enrollment regulation will ... Read more
Beware Carrier-specific Edits
It's important to be aware of new National Correct Coding Initiative edits so you ca... Read more
It's important to be aware of new National Correct Coding Initiative edits so you ca... Read more
CPT:
NCCI Hits New Codes With Tons of Edits
The American Medical Association introduced many new codes in the 2003 edition of the CP... Read more
NCCI Hits New Codes With Tons of Edits
The American Medical Association introduced many new codes in the 2003 edition of the CP... Read more
Coverage:
Medicare Stingy When It Comes to Stent Bundling
The Food & Drug Administra-tion only just approved the first drug-eluting stent from J... Read more
Medicare Stingy When It Comes to Stent Bundling
The Food & Drug Administra-tion only just approved the first drug-eluting stent from J... Read more
NCCI:
Edits Brings Changes to Endoscopy Coding
Gastroenterologists will have a much harder time billing for common procedures in the wake... Read more
Edits Brings Changes to Endoscopy Coding
Gastroenterologists will have a much harder time billing for common procedures in the wake... Read more
Physician Payments:
Congressmen Call For Drug-Free Physician Growth Rate
Physicians are getting shafted because drug expenses make their payments look as if they'r... Read more
Congressmen Call For Drug-Free Physician Growth Rate
Physicians are getting shafted because drug expenses make their payments look as if they'r... Read more
MEDICARE OVERHAUL:
Physicians, Brace Yourselves for Medicare Reform
A Medicare reform plan could pass as soon as this summer, but you're not likely to see the... Read more
Physicians, Brace Yourselves for Medicare Reform
A Medicare reform plan could pass as soon as this summer, but you're not likely to see the... Read more
Medicare Prescription Drugs:
SENATE FINANCE PRODUCES BIPARTISAN Rx PLAN
Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and ranking Democrat Max Baucus ... Read more
SENATE FINANCE PRODUCES BIPARTISAN Rx PLAN
Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and ranking Democrat Max Baucus ... Read more
Medicare Private Plans:
Nudging Patients Into Private Health Plans
Physicians may still have to deal with preferred provider organizations, but it won't be i... Read more
Nudging Patients Into Private Health Plans
Physicians may still have to deal with preferred provider organizations, but it won't be i... Read more
Payment Revisions:
Eye Surgeons Win Boost as CMS Reviews RVUs
Good news for physicians billing for voice prosthetics and eye surgery codes. The quarterl... Read more
Eye Surgeons Win Boost as CMS Reviews RVUs
Good news for physicians billing for voice prosthetics and eye surgery codes. The quarterl... Read more
Drugs:
Jan. 1 Could Be D-Day for Drug Payments
Oncologists and others who dispense medications under Medicare could be under the gun in a... Read more
Jan. 1 Could Be D-Day for Drug Payments
Oncologists and others who dispense medications under Medicare could be under the gun in a... Read more
OIG Excludes 200 per Month
Heads up, physicians. The HHS Office of Inspector General is out for blood. In its latest ... Read more
Heads up, physicians. The HHS Office of Inspector General is out for blood. In its latest ... Read more
Studies & Surveys:
Emergency Care Costs Doctors $4.2 Billion a Year
Think it's just emergency department physicians who suffer from unreimbursed emergency car... Read more
Emergency Care Costs Doctors $4.2 Billion a Year
Think it's just emergency department physicians who suffer from unreimbursed emergency car... Read more
Coverage:
ICD COVERAGE EXPANDS - BUT ONLY SLIGHTLY
Healthcare providers will soon be able to bill Medicare for implantable cardioverter def... Read more
ICD COVERAGE EXPANDS - BUT ONLY SLIGHTLY
Healthcare providers will soon be able to bill Medicare for implantable cardioverter def... Read more
REIMBURSEMENT:
New Guidelines Mean Broader Application of Deep Brain Stimulation Codes
New guidelines from the Centers for Medicare & Medicaid Services have allowed for broa... Read more
New Guidelines Mean Broader Application of Deep Brain Stimulation Codes
New guidelines from the Centers for Medicare & Medicaid Services have allowed for broa... Read more
Don't Forget to Charge for Programming
Following implantation of a DBS unit, the surgeon (or a neurologist) must test the device ... Read more
Following implantation of a DBS unit, the surgeon (or a neurologist) must test the device ... Read more
Coding:
Add Prolonged Services to Applicable E/M Only
If you're billing for prolonged service codes 99354-99357, you should be careful to avoid ... Read more
Add Prolonged Services to Applicable E/M Only
If you're billing for prolonged service codes 99354-99357, you should be careful to avoid ... Read more
Legislation:
SENATORS AGREE ON GENERIC DRUG BILL
A bipartisan compromise announced June 5 means the Senate is again likely to pass legislat... Read more
SENATORS AGREE ON GENERIC DRUG BILL
A bipartisan compromise announced June 5 means the Senate is again likely to pass legislat... Read more
Coverage:
Beneficiary Rage Leads to Likely Coverage
Taking the Centers for Medicare & Medicaid Services to court proved a worthwhile strat... Read more
Beneficiary Rage Leads to Likely Coverage
Taking the Centers for Medicare & Medicaid Services to court proved a worthwhile strat... Read more
Reimbursement:
An ED Visit and a Hospital Admission on the Same Day? Earn Proper Payment
How can you code for optimal reimbursement if the surgeon sees a patient in the emergency ... Read more
An ED Visit and a Hospital Admission on the Same Day? Earn Proper Payment
How can you code for optimal reimbursement if the surgeon sees a patient in the emergency ... Read more
Coding:
Can't Decide Between -51 and -59? Here's How to Choose
Physicians, coders and payers alike often have trouble distinguishing between modifiers ... Read more
Can't Decide Between -51 and -59? Here's How to Choose
Physicians, coders and payers alike often have trouble distinguishing between modifiers ... Read more
Physician Notes:
Radiologist-Hospital JV Clears Anti-Kickback Hurdles
The fact that radiologists don't typically order the tests they perform allowed an otherwi... Read more
Radiologist-Hospital JV Clears Anti-Kickback Hurdles
The fact that radiologists don't typically order the tests they perform allowed an otherwi... Read more
POLITICS & POLICY:
Senate Rural Health Plan Goes Back To The Barn
A U.S. Senate amendment to the Republican tax bill that would have boosted payments to rur... Read more
Senate Rural Health Plan Goes Back To The Barn
A U.S. Senate amendment to the Republican tax bill that would have boosted payments to rur... Read more
REIMBURSEMENT:
Rural Reforms Snard in Medicare Reform Tangle
Now that the U.S. House of Representatives has shot down Sen. Charles Grassley's (R-Iowa) ... Read more
Rural Reforms Snard in Medicare Reform Tangle
Now that the U.S. House of Representatives has shot down Sen. Charles Grassley's (R-Iowa) ... Read more
Providers Still Working on SGR Fix
Providers continue to work on Capitol Hill to win reform of the formula Medicare uses to s... Read more
Providers continue to work on Capitol Hill to win reform of the formula Medicare uses to s... Read more
Appeals:
Avoid Appeals Doldrums With Documentation
Cash-strapped carriers may begin pushing your appeals to the bottom of their in-boxes unle... Read more
Avoid Appeals Doldrums With Documentation
Cash-strapped carriers may begin pushing your appeals to the bottom of their in-boxes unle... Read more
RVUS:
CMS Slashes More Than a Dozen Codes
CMS giveth, and CMS taketh away. At the start of 2003, the Centers for Medicare &... Read more
CMS Slashes More Than a Dozen Codes
CMS giveth, and CMS taketh away. At the start of 2003, the Centers for Medicare &... Read more
COMPLIANCE PERSPECTIVES:
Docs' Coding Savvu Can Boost Reimbursement, Enhance Compliance
Many physicians are loathe to add coding knowledge to their repertoire, but biting the c... Read more
Docs' Coding Savvu Can Boost Reimbursement, Enhance Compliance
Many physicians are loathe to add coding knowledge to their repertoire, but biting the c... Read more
Understand Modifiers for Non-Covered Services
Want to bill Medicare for a service you're sure it's going to deny? You still need to appe... Read more
Want to bill Medicare for a service you're sure it's going to deny? You still need to appe... Read more
COVERAGE:
National Coverage Policies Should Rule, Report Says
Confused by your carrier's local coverage policies? If the General Accounting Office gets... Read more
National Coverage Policies Should Rule, Report Says
Confused by your carrier's local coverage policies? If the General Accounting Office gets... Read more
LOCAL COVERAGE POLICIES:
CIGNA Policies Limit Sinus Endoscopy
In Tennessee, Cigna Healthcare unveiled two new draft local medical review policies with c... Read more
CIGNA Policies Limit Sinus Endoscopy
In Tennessee, Cigna Healthcare unveiled two new draft local medical review policies with c... Read more
REIMBURSEMENT:
When You Take Extra Time, Make It Count
If your physician is spending more than the usual amount of time with a patient, you could... Read more
When You Take Extra Time, Make It Count
If your physician is spending more than the usual amount of time with a patient, you could... Read more
ABNs:
Game of Musical Diagnoses Leaves Patient Without Chair
A signed advance beneficiary notice gives you the right to tell a patient, "I told ... Read more
Game of Musical Diagnoses Leaves Patient Without Chair
A signed advance beneficiary notice gives you the right to tell a patient, "I told ... Read more
LUNG-VOLUME REDUCTION:
Study Suggests Who Gains From Disputed Surgery
The Centers for Medicare & Medicaid Services opened a national coverage determination ... Read more
Study Suggests Who Gains From Disputed Surgery
The Centers for Medicare & Medicaid Services opened a national coverage determination ... Read more
MEDICARE REFORM:
AWP Cuts, Redistribution Not Dead Yet
Rural physicians can cling to hope of relief on Medicare payment levels, while oncologists... Read more
AWP Cuts, Redistribution Not Dead Yet
Rural physicians can cling to hope of relief on Medicare payment levels, while oncologists... Read more
MEDICARE REFORM:
Grassley Provisions Unpopular With Many
The cancer community, including patient advocacy groups, oncologists, oncology nurses and ... Read more
Grassley Provisions Unpopular With Many
The cancer community, including patient advocacy groups, oncologists, oncology nurses and ... Read more
PHYSICIAN NOTES:
Carriers Tout Safeguard Hauls
Medicare carriers are boasting once again about the financial fallout from their medical r... Read more
Carriers Tout Safeguard Hauls
Medicare carriers are boasting once again about the financial fallout from their medical r... Read more
CHART:
Prolonged Services
Documentation of physician time is critical to charge for prolonged services (CPT 99354 f... Read more
Prolonged Services
Documentation of physician time is critical to charge for prolonged services (CPT 99354 f... Read more
CORRECT CODING INITIATIVE:
CMS Reverses CCI Edits for TEE
When the doors of reimbursement close on a procedure you perform regularly, don't de... Read more
CMS Reverses CCI Edits for TEE
When the doors of reimbursement close on a procedure you perform regularly, don't de... Read more
DIAGNOSIS CODING:
When Can V Codes Stand Alone?
How long after you remove a tumor can it serve as the primary diagnosis for follow-up visi... Read more
When Can V Codes Stand Alone?
How long after you remove a tumor can it serve as the primary diagnosis for follow-up visi... Read more
TELEMEDICINE:
Telemedicine, Regular Medicine Both Have Same Result
What's the difference between counseling someone on managing her diabetes via video and in... Read more
Telemedicine, Regular Medicine Both Have Same Result
What's the difference between counseling someone on managing her diabetes via video and in... Read more
FRAUD & ABUSE:
OIG May Dislocate Your Joint Venture
Durable medical equipment companies won a starring role in the HHS Office of Inspector Gen... Read more
OIG May Dislocate Your Joint Venture
Durable medical equipment companies won a starring role in the HHS Office of Inspector Gen... Read more
COVERAGE:
CMS Plans to Reach Out for Tech Advice
If you think you're having a hard time keeping up with the galloping advances in medical t... Read more
CMS Plans to Reach Out for Tech Advice
If you think you're having a hard time keeping up with the galloping advances in medical t... Read more
LMRPS:
Carriers Unveil Spate of Draft LMRPs
Need summer beach reading? Your carrier may have just the thing. Carriers are putting out... Read more
Carriers Unveil Spate of Draft LMRPs
Need summer beach reading? Your carrier may have just the thing. Carriers are putting out... Read more
INCIDENT-TO BILLING:
Ask Your Local Carrier About Incident-To Requirements
How far away from a physician can nonphysician practitioners stray before incident-to bill... Read more
Ask Your Local Carrier About Incident-To Requirements
How far away from a physician can nonphysician practitioners stray before incident-to bill... Read more
CODING:
Are You Using Modifier -59 Correctly? Quick Test Will Say for Sure
If you're slapping modifier -59 on your claims like there's no tomorrow, doomsda... Read more
Are You Using Modifier -59 Correctly? Quick Test Will Say for Sure
If you're slapping modifier -59 on your claims like there's no tomorrow, doomsda... Read more
COMPLIANCE:
Drugmaker Guidance Could Have Wide Reach to Physicians
If you're accepting free services or payments as an inducement to prescribe a particular d... Read more
Drugmaker Guidance Could Have Wide Reach to Physicians
If you're accepting free services or payments as an inducement to prescribe a particular d... Read more
DIAGNOSIS CODING:
CDC Readies New ICD-9 Codes
Starting in October, you could have a whole new way to look at Pap smear aftercare, hepati... Read more
CDC Readies New ICD-9 Codes
Starting in October, you could have a whole new way to look at Pap smear aftercare, hepati... Read more
Physicians Still Lag on HIPAA, Survey Says
The compliance deadline for the HIPAAprivacy rule has come and gone - but physicians still... Read more
The compliance deadline for the HIPAAprivacy rule has come and gone - but physicians still... Read more
DOCTOR'S NOTES:
Physician Payment Reforms Could Be on the Way
Don't panic! That's the message one prominent Washington law firm is sending physicians. ... Read more
Physician Payment Reforms Could Be on the Way
Don't panic! That's the message one prominent Washington law firm is sending physicians. ... Read more
Look Twice at These 5 JV Warning Signs
You should take notice if your joint venture exhibits any of the following five elements, ... Read more
You should take notice if your joint venture exhibits any of the following five elements, ... Read more
UPCODING:
E/M Upcoding Leads to $1.36 Million Payout
Here's one more reason to be sure your evaluation and management coding practices ar... Read more
E/M Upcoding Leads to $1.36 Million Payout
Here's one more reason to be sure your evaluation and management coding practices ar... Read more
COMPLIANCE:
'Set-In-Advance' Stark Setback Buys Physicians Time
Teaching hospitals and medical foundations bracing for a potential paperwork nightmare Jul... Read more
'Set-In-Advance' Stark Setback Buys Physicians Time
Teaching hospitals and medical foundations bracing for a potential paperwork nightmare Jul... Read more
Montana Blues Sings Apologetic Song
One carrier took April Fools' Day a little too far this year, it now admits. Blue Cross an... Read more
One carrier took April Fools' Day a little too far this year, it now admits. Blue Cross an... Read more
REIMBURSEMENT:
Know 'Hot Buttons' Before You Press Them
Stop! Are you dangling audit bait in the water? Certain codes are almost guaranteed to at... Read more
Know 'Hot Buttons' Before You Press Them
Stop! Are you dangling audit bait in the water? Certain codes are almost guaranteed to at... Read more
CODING:
If You're Downcoding on Purpose, You're Burning Cash
Many physicians are so beaten down by fraud probes and carrier audits that they're punishi... Read more
If You're Downcoding on Purpose, You're Burning Cash
Many physicians are so beaten down by fraud probes and carrier audits that they're punishi... Read more
Congress Pays for SARS, Smallpox
The $79 billion supplemental spending bill for fiscal year 2003 includes $2.23 billion for... Read more
The $79 billion supplemental spending bill for fiscal year 2003 includes $2.23 billion for... Read more
COVERAGE:
PET Scans Now Covered for Thyroid Cancer and Cardiac Diseases
If your clinic performs positron emission tomography scans, you could be in for a big boos... Read more
PET Scans Now Covered for Thyroid Cancer and Cardiac Diseases
If your clinic performs positron emission tomography scans, you could be in for a big boos... Read more
COVERAGE:
Don't Leap Past Basic Exams to Expensive Test
Soon you'll have a new diagnostic tool for arterial problems - but don't overuse it, or yo... Read more
Don't Leap Past Basic Exams to Expensive Test
Soon you'll have a new diagnostic tool for arterial problems - but don't overuse it, or yo... Read more
TEACHING HOSPITALS:
Doctor Pays Fine for Wandering off PATH
Physician-presence rules in the teaching hospital setting are among the oldest compliance ... Read more
Doctor Pays Fine for Wandering off PATH
Physician-presence rules in the teaching hospital setting are among the oldest compliance ... Read more
DIAGNOSIS CODING:
CMN Doesn't Need to Justify Diagnosis Code, CMS Says
You may still be in the dark as to which ICD9 Codes to put on a claim, especially in cas... Read more
CMN Doesn't Need to Justify Diagnosis Code, CMS Says
You may still be in the dark as to which ICD9 Codes to put on a claim, especially in cas... Read more
FRAUD & ABUSE:
Physician Deals With Hospitals Are Under Scrutiny
If your practice is working with a hospital, you may be in for scrutiny from the feds. Jus... Read more
Physician Deals With Hospitals Are Under Scrutiny
If your practice is working with a hospital, you may be in for scrutiny from the feds. Jus... Read more
CODING:
Don't Let the Bell Curve Fool You
If you're concerned that you may be downcoding, then it's important to have a ce... Read more
Don't Let the Bell Curve Fool You
If you're concerned that you may be downcoding, then it's important to have a ce... Read more
HIPAA:
Lawsuit Aims to Slow HIPAA Juggernaut
Privacy advocates and other healthcare groups representing patients who charge that the He... Read more
Lawsuit Aims to Slow HIPAA Juggernaut
Privacy advocates and other healthcare groups representing patients who charge that the He... Read more
CODING:
New Codes Mean Changes for Billing Surgical Dressings, Defibrillators
Physicians and suppliers have a host of new "K" codes to get familiar with thanks to a tri... Read more
New Codes Mean Changes for Billing Surgical Dressings, Defibrillators
Physicians and suppliers have a host of new "K" codes to get familiar with thanks to a tri... Read more
INFUSION:
At Your Service, IV Providers Tell Medicare
Instead of paying per widget, the home-infusion industry wants Medicare to pay per diem fo... Read more
At Your Service, IV Providers Tell Medicare
Instead of paying per widget, the home-infusion industry wants Medicare to pay per diem fo... Read more
MODIFIERS:
Your Billing May Revolve Around Global Periods
If a patient comes back after surgery with a problem related to the diagnosis that caused ... Read more
Your Billing May Revolve Around Global Periods
If a patient comes back after surgery with a problem related to the diagnosis that caused ... Read more
COMPLIANCE:
Considering E-Mail Consultations? Read This First
The point-and-click era has patients clamoring for electronic access to their physicians, ... Read more
Considering E-Mail Consultations? Read This First
The point-and-click era has patients clamoring for electronic access to their physicians, ... Read more
MEDICAL REVIEW:
Bring Medical Review Into Greater Focus
Why is the insurance carrier picking on you? It may seem random, but there's usually... Read more
Bring Medical Review Into Greater Focus
Why is the insurance carrier picking on you? It may seem random, but there's usually... Read more
FRAUD & ABUSE:
OIG Heats Up Griddle the Carriers Make You Dance On
You may be hearing frequently from carriers about some codes you bill often, but it coul... Read more
OIG Heats Up Griddle the Carriers Make You Dance On
You may be hearing frequently from carriers about some codes you bill often, but it coul... Read more
DRUG REIMBURSEMENT:
CMS Invites Least Costly Alternative for Drugs
Medicare's new Single Drug Pricer doesn't mean that the Centers for Medicare & Medicai... Read more
CMS Invites Least Costly Alternative for Drugs
Medicare's new Single Drug Pricer doesn't mean that the Centers for Medicare & Medicai... Read more
PHYSICIAN NOTES:
CDC Sees HIV as Fertile Ground for Prevention
"Prevention efforts have stalled" on HIV, with 40,000 new infections now occurring annuall... Read more
CDC Sees HIV as Fertile Ground for Prevention
"Prevention efforts have stalled" on HIV, with 40,000 new infections now occurring annuall... Read more
ENROLLMENT:
Providers, Suppliers Face New Enrollment Standards
A wider range of Medicare providers could be subject to site visits to verify their enroll... Read more
Providers, Suppliers Face New Enrollment Standards
A wider range of Medicare providers could be subject to site visits to verify their enroll... Read more
How Can You Bill for Aborted Anesthesia?
4 tips for billing for anesthesia with canceled procedures If the surgeon or anesthe... Read more
4 tips for billing for anesthesia with canceled procedures If the surgeon or anesthe... Read more
Coverage:
Carrier Relents on Mohs Coverage Cutback
Letter-writing campaign works, but other carriers may be recalcitrant If your surgeon... Read more
Carrier Relents on Mohs Coverage Cutback
Letter-writing campaign works, but other carriers may be recalcitrant If your surgeon... Read more
Carrier Warpath Just Part Of Skin Lesion Fight
You may think it's no skin off your nose if carriers slice away Mohs coverage, but you'd b... Read more
You may think it's no skin off your nose if carriers slice away Mohs coverage, but you'd b... Read more
The Patient Is Sedated, the Surgeon Calls It Quits:
What Should You Bill?
Can you bill for anesthetic when the procedure didn't actually happen? An anesthetist's ti... Read more
What Should You Bill?
Can you bill for anesthetic when the procedure didn't actually happen? An anesthetist's ti... Read more
New Alzheimer's Drug Approved
There's a new treatment option for people with advanced Alzheimer's disease. The U.S.... Read more
There's a new treatment option for people with advanced Alzheimer's disease. The U.S.... Read more
Modifiers:
Give Carriers a Comparable Procedure to Win Extra Reimbursement
Master modifiers -22 and -52 to get on top of abnormally big or small procedures No t... Read more
Give Carriers a Comparable Procedure to Win Extra Reimbursement
Master modifiers -22 and -52 to get on top of abnormally big or small procedures No t... Read more
Premiums Increase For 2004
Once again, the Department of Health and Human Services has increased the Medicare premium... Read more
Once again, the Department of Health and Human Services has increased the Medicare premium... Read more
AMPUTATION:
Global Periods Rule the World of Amputation
But here are some ways to receive payment before and after anyway When you take part ... Read more
Global Periods Rule the World of Amputation
But here are some ways to receive payment before and after anyway When you take part ... Read more
Physician Notes:
Watch Your ASP Coding
The feds are watching place-of-service codes Physician Practice that perform ambulatory s... Read more
Watch Your ASP Coding
The feds are watching place-of-service codes Physician Practice that perform ambulatory s... Read more
Diagnostic Tests:
How to Bill 76092 on the Same Day As 76090 or 76091
When screening mammograms turn diagnostic, it's important to be agnosticGood news can some... Read more
How to Bill 76092 on the Same Day As 76090 or 76091
When screening mammograms turn diagnostic, it's important to be agnosticGood news can some... Read more
Consults:
How to Avoid Adding Consult to Injury
The OIG's bark may be worse than its biteBilling for consults may be a mine field, but it'... Read more
How to Avoid Adding Consult to Injury
The OIG's bark may be worse than its biteBilling for consults may be a mine field, but it'... Read more
Document the Need for Consults
While it's true that some physicians are too cautious about billing for consults, others g... Read more
While it's true that some physicians are too cautious about billing for consults, others g... Read more
Accounting:
How to Cope With High A/R Without Going Nuts
6 tips for cleaning up accounts receivable disastersIt's like cleaning out the fridge. Sor... Read more
How to Cope With High A/R Without Going Nuts
6 tips for cleaning up accounts receivable disastersIt's like cleaning out the fridge. Sor... Read more
Deadly Don'ts Of Accounts Receivable Billing
Watch out for these 4 mistakes practices often make If you're making some common m... Read more
Watch out for these 4 mistakes practices often make If you're making some common m... Read more
Coverage:
Learn the New LMRPs Before They Apply to You
The Part B carriers are constantly hard at work defining what Medicare will cover in their... Read more
Learn the New LMRPs Before They Apply to You
The Part B carriers are constantly hard at work defining what Medicare will cover in their... Read more
Observation:
Learn The TAO Of Observation Coding
3 simple rules for when to bill for observation Many providers are confused about when th... Read more
Learn The TAO Of Observation Coding
3 simple rules for when to bill for observation Many providers are confused about when th... Read more
Screening Tests:
5 Mistakes You May Be Making With Billing for Pap Smears/Pelvic Exams
Learn where the pitfalls are before you fall inMost coders know that Medicare covers G010... Read more
5 Mistakes You May Be Making With Billing for Pap Smears/Pelvic Exams
Learn where the pitfalls are before you fall inMost coders know that Medicare covers G010... Read more
Physician Notes:
Pathology Services Payments Could Face an Overhaul
Hospitals and laboratories will be negotiating a flurry of new contracts soon if the Gener... Read more
Pathology Services Payments Could Face an Overhaul
Hospitals and laboratories will be negotiating a flurry of new contracts soon if the Gener... Read more
CPT changes:
2004 CPT Codes Trickle Out
New codes for fluoroscopy and mammography, plus new definitions The 2004 Curr... Read more
2004 CPT Codes Trickle Out
New codes for fluoroscopy and mammography, plus new definitions The 2004 Curr... Read more
Foot Care:
LOPS Versus Routine Foot Care?
Beware 180-day global period around LOPS codesSome practices are overusing the diagnosis o... Read more
LOPS Versus Routine Foot Care?
Beware 180-day global period around LOPS codesSome practices are overusing the diagnosis o... Read more
Know Your LOPS Codes
Medicare recognizes three codes for LOPS treatment: G0245 (Initial physician evaluat... Read more
Medicare recognizes three codes for LOPS treatment: G0245 (Initial physician evaluat... Read more
Some New Codes From 2004 CPT Update
CPT 20982 - Ablation, bone tumor(s) (e.g., osteoid osteoma, metastasis) radiofrequency,... Read more
CPT 20982 - Ablation, bone tumor(s) (e.g., osteoid osteoma, metastasis) radiofrequency,... Read more
Coverage:
Half a Loaf of Coverage Improvements Is Better Than None
CMS promises to speed up considerationThe Centers for Medicare & Medicaid Services fin... Read more
Half a Loaf of Coverage Improvements Is Better Than None
CMS promises to speed up considerationThe Centers for Medicare & Medicaid Services fin... Read more
HIP-HIP HOORAY FOR HIPAA DELAY
Medicare contingency plan will permit noncompliant claims If you feared that the Oct. 16 ... Read more
Medicare contingency plan will permit noncompliant claims If you feared that the Oct. 16 ... Read more
EECP Coding:
Use G0166, Not CPT Codes, for EECP Under Medicare
Make sure you have coverage for this big-ticket therapy Confused about enhanced exter... Read more
Use G0166, Not CPT Codes, for EECP Under Medicare
Make sure you have coverage for this big-ticket therapy Confused about enhanced exter... Read more
Physician Notes:
Medicare Reform Legislation Looks Less Likely This Year
Thirteen GOP representatives who voted "reluctantly" for the House Medicare bi... Read more
Medicare Reform Legislation Looks Less Likely This Year
Thirteen GOP representatives who voted "reluctantly" for the House Medicare bi... Read more
Cochlear Implants:
Avoid Noncovered Codes For Speech Devices, Swallowing Tests
Try billing 31575 instead of 92613, 92615 or 92617The 2003 CPT added new codes for cochlea... Read more
Avoid Noncovered Codes For Speech Devices, Swallowing Tests
Try billing 31575 instead of 92613, 92615 or 92617The 2003 CPT added new codes for cochlea... Read more
Sleep Studies:
Don't Sleep on Medicare Sleep Study Reimbursement
Extra parameters add $180 to reimbursement Sleep can be a complicated business, and monito... Read more
Don't Sleep on Medicare Sleep Study Reimbursement
Extra parameters add $180 to reimbursement Sleep can be a complicated business, and monito... Read more
Hospital Billing:
Use -TC and -26 Modifiers
In a freestanding sleep clinic, Charlotte Ware says, a physician practice should b... Read more
Use -TC and -26 Modifiers
In a freestanding sleep clinic, Charlotte Ware says, a physician practice should b... Read more
Medical Decision-Making:
Chronic Complaints Mean Low Levels? Not So Fast
Don't cheat yourself on medical decision-making for chronic patientsWhen a patient comes i... Read more
Chronic Complaints Mean Low Levels? Not So Fast
Don't cheat yourself on medical decision-making for chronic patientsWhen a patient comes i... Read more
Injections:
Doctors Confuse 20552 With 20551, Risk Audits
Understand the difference between trigger points and tendon sheathsIt used to be that you ... Read more
Doctors Confuse 20552 With 20551, Risk Audits
Understand the difference between trigger points and tendon sheathsIt used to be that you ... Read more
Don't Let Time-Dependent Codes Land You In Time-Out
The last thing physicians want to do is watch the clock, but if you don't document the tim... Read more
The last thing physicians want to do is watch the clock, but if you don't document the tim... Read more
Coding:
Two E/M Services, Two Visits - One Claim?
When is it OK to combine two E/M services into one? Nothing is more confusing than d... Read more
Two E/M Services, Two Visits - One Claim?
When is it OK to combine two E/M services into one? Nothing is more confusing than d... Read more
Physician Notes:
Don't Hold Your Breath for Medicare Legislation
Congressional leaders have returned to their Medicare and prescription drug bill negotiat... Read more
Don't Hold Your Breath for Medicare Legislation
Congressional leaders have returned to their Medicare and prescription drug bill negotiat... Read more
National Correct Coding Initiative:
Version 9.2 Promises Big Changes for Cardiology Coding
Heads up, cardiologists: If you're repositioning a pacemaker or electrode, you won't be ab... Read more
Version 9.2 Promises Big Changes for Cardiology Coding
Heads up, cardiologists: If you're repositioning a pacemaker or electrode, you won't be ab... Read more
Diagnosis Codes:
Providing ICD-9s for Lab Claims Just Became Your Job, CMS Says 'No' to Suspected Diagnoses
When you order labs, you don't always know what diagnosis the patient will end up ha... Read more
Providing ICD-9s for Lab Claims Just Became Your Job, CMS Says 'No' to Suspected Diagnoses
When you order labs, you don't always know what diagnosis the patient will end up ha... Read more
Chill out with ICD-9s
The biggest change stemming from this new memo seems to be that CMS is leaning on physic... Read more
The biggest change stemming from this new memo seems to be that CMS is leaning on physic... Read more
Studies & Surveys:
Physicians Capacity at the Breaking Point, Study Says, Medicare Patients Wait Longer for Fewer Services
Patients are waiting longer for appointments, and doctors don't have enough time with each... Read more
Physicians Capacity at the Breaking Point, Study Says, Medicare Patients Wait Longer for Fewer Services
Patients are waiting longer for appointments, and doctors don't have enough time with each... Read more
NCCI:
Mutually Exclusive Edits Threaten Reimbursement
The July release of the National Correct Coding Initiative includes only 111 mutuall... Read more
Mutually Exclusive Edits Threaten Reimbursement
The July release of the National Correct Coding Initiative includes only 111 mutuall... Read more
Hematology:
New Edits Clarify: Don't Bill Consultation on Slides
Billing for hematology just became a puzzle again, thanks to a raft of new National Correc... Read more
New Edits Clarify: Don't Bill Consultation on Slides
Billing for hematology just became a puzzle again, thanks to a raft of new National Correc... Read more
Coverage:
Medicare Expands PET Scan Coverage
The Centers for Medicare & Medicaid Services continues to make it possible to bill for... Read more
Medicare Expands PET Scan Coverage
The Centers for Medicare & Medicaid Services continues to make it possible to bill for... Read more
Physician's Notes:
Dueling Proposals Compete to Reform Medicare, Physicians Caught in the Crossfire
... Read more
Dueling Proposals Compete to Reform Medicare, Physicians Caught in the Crossfire
... Read more
CODING:
Don't Let Defunct Edits Bite Into Your Reimbursement
If you're relying on your software to digest the Correct Coding Initiative edits , you co... Read more
Don't Let Defunct Edits Bite Into Your Reimbursement
If you're relying on your software to digest the Correct Coding Initiative edits , you co... Read more
PARTICIPATION:
July 'Double Whammy' Could Hit Nonparticipating Hardest
It just keeps getting more and more confusing. Now, not only will your payments from Janu... Read more
July 'Double Whammy' Could Hit Nonparticipating Hardest
It just keeps getting more and more confusing. Now, not only will your payments from Janu... Read more
CCI:
April Brings Dozens of New CCI Edits
Attention, coders! Forget last month's coding rulebook, because it's a whole new... Read more
April Brings Dozens of New CCI Edits
Attention, coders! Forget last month's coding rulebook, because it's a whole new... Read more
CCI:
Where Modifiers Won't Help, You Must Modify Your Behavior
Bad news for coders: Your ingenuity in using modifiers as a way of getting around correc... Read more
Where Modifiers Won't Help, You Must Modify Your Behavior
Bad news for coders: Your ingenuity in using modifiers as a way of getting around correc... Read more
MEDICARE:
OIG Gives Coding Company a Seminar in Pain
Have you been duped by coding and billing education companies that tout nonexistent formal... Read more
OIG Gives Coding Company a Seminar in Pain
Have you been duped by coding and billing education companies that tout nonexistent formal... Read more
STUDIES & SURVEYS:
Physicians Tightening Access for Medicare Patients
More and more physicians are hesitating to take on new Medicare patients - but they stil... Read more
Physicians Tightening Access for Medicare Patients
More and more physicians are hesitating to take on new Medicare patients - but they stil... Read more
TEAR-OUT GUIDE:
Take Note of Added, Deleted ASC Codes
If you don't have hours to spend culling the Federal Register for the correct codes to use... Read more
Take Note of Added, Deleted ASC Codes
If you don't have hours to spend culling the Federal Register for the correct codes to use... Read more
COVERAGE:
New Radiation Reimbursement Restrictions Could Burn You
Cahaba GBA announced a policy on coverage of intensely moderated radiation therapy (IMRT... Read more
New Radiation Reimbursement Restrictions Could Burn You
Cahaba GBA announced a policy on coverage of intensely moderated radiation therapy (IMRT... Read more
COVERAGE:
Dx Should Be Reason for Extra Nursing Home Visits
If a physician visits a nursing home patient more frequently than Medicare will usually co... Read more
Dx Should Be Reason for Extra Nursing Home Visits
If a physician visits a nursing home patient more frequently than Medicare will usually co... Read more
APPEALS:
Carrier Reps Catch Customer-Service Spirit
The next time you call your carrier, you may be on hold for a little less time. The Ce... Read more
Carrier Reps Catch Customer-Service Spirit
The next time you call your carrier, you may be on hold for a little less time. The Ce... Read more
MODIFIERS:
Know Global Period Rules to Avoid a World of Trouble
If you're trying to bill for new services during the global period after a major procedure... Read more
Know Global Period Rules to Avoid a World of Trouble
If you're trying to bill for new services during the global period after a major procedure... Read more
ASSOCIATIONS:
Coders Should Have Access to Member Areas
Want to make sure you're billing in the most up-to-date code combinations and keepin... Read more
Coders Should Have Access to Member Areas
Want to make sure you're billing in the most up-to-date code combinations and keepin... Read more
CODING:
Suppliers Divide and Conquer Disputed Code
Want to write your own codes? Build a big tent and invite everyone in. That's the approac... Read more
Suppliers Divide and Conquer Disputed Code
Want to write your own codes? Build a big tent and invite everyone in. That's the approac... Read more
INDUSTRY NOTES:
Earn CMEs for Quality Improvement
Physicians have one more incentive to get involved with the Centers for Medicare & Med... Read more
Earn CMEs for Quality Improvement
Physicians have one more incentive to get involved with the Centers for Medicare & Med... Read more
PRESCRIPTION DRUGS:
Family Practitioners, Oncologists Hit by Drug Cuts
The Centers for Medicare & Medicaid Services unveiled a "dirty baker's dozen" of cuts ... Read more
Family Practitioners, Oncologists Hit by Drug Cuts
The Centers for Medicare & Medicaid Services unveiled a "dirty baker's dozen" of cuts ... Read more
FRAUD & ABUSE:
Your Patients Are Watching You
If your explanation-of-benefits forms look suspicious to some of your patients, don't be s... Read more
Your Patients Are Watching You
If your explanation-of-benefits forms look suspicious to some of your patients, don't be s... Read more
TO PARTICIPATE OR NOT?
It makes sense for the Centers for Medicare & Medicaid Services to do things to encour... Read more
It makes sense for the Centers for Medicare & Medicaid Services to do things to encour... Read more
PHYSICIAN PAYMENTS:
'Vicious Cycle' Runs Over Physician Payments
Enjoy that 1.6 percent payment increase for 2003. It could be the last boost you see for s... Read more
'Vicious Cycle' Runs Over Physician Payments
Enjoy that 1.6 percent payment increase for 2003. It could be the last boost you see for s... Read more
HIPAA HELP:
Piggyback Privacy Rule To Make Security Compliance Load Bearable
There's good news and there's bad news about the HIPAA security rule. The bad news is that... Read more
Piggyback Privacy Rule To Make Security Compliance Load Bearable
There's good news and there's bad news about the HIPAA security rule. The bad news is that... Read more
PHYSICIAN PAYMENTS:
Can Anything Save Physician Payments?
Now it's clearer than ever that physicians will suffer negative updates for the next few y... Read more
Can Anything Save Physician Payments?
Now it's clearer than ever that physicians will suffer negative updates for the next few y... Read more
MEDICAL REVIEW:
Order Lab Tests And You May Hear From Carrier Reviewers
You now have only two weeks, instead of three, to respond to suspensions, offsets or rec... Read more
Order Lab Tests And You May Hear From Carrier Reviewers
You now have only two weeks, instead of three, to respond to suspensions, offsets or rec... Read more
MEDICARE REFORM:
Is The Bush Medicare Reform Plan DOA?
Nobody ever accused fee-for-service Medicare of being simple, but you might find yourself ... Read more
Is The Bush Medicare Reform Plan DOA?
Nobody ever accused fee-for-service Medicare of being simple, but you might find yourself ... Read more
CODING:
Don't Overbill For Stable Nursing Home Patients
When the doctor drops by the nursing home, it barely seems worthwhile to bill the lowest... Read more
Don't Overbill For Stable Nursing Home Patients
When the doctor drops by the nursing home, it barely seems worthwhile to bill the lowest... Read more
CODING COMPLIANCE:
4 Tips For Painless Lesion Excision Coding
Lesions: All physicians have to deal with them in one capacity or another, and they are ... Read more
4 Tips For Painless Lesion Excision Coding
Lesions: All physicians have to deal with them in one capacity or another, and they are ... Read more
EVALUATION & MANAGEMENT:
Outpatient Teaching Doctors Face Confusion
When the Centers for Medicare & Medicaid Services unveiled new documentation requireme... Read more
Outpatient Teaching Doctors Face Confusion
When the Centers for Medicare & Medicaid Services unveiled new documentation requireme... Read more
COMPLIANCE:
Don't Be Too Forward, OIG Tells Carriers
The check may be in the mail - but you may never see it anyway. A mix-up with the address... Read more
Don't Be Too Forward, OIG Tells Carriers
The check may be in the mail - but you may never see it anyway. A mix-up with the address... Read more
STUDIES & SURVEYS:
Less Is More, Says MedPAC
Some regions of the country are spending 60 percent more per patient on health care than o... Read more
Less Is More, Says MedPAC
Some regions of the country are spending 60 percent more per patient on health care than o... Read more
PRESCRIPTION DRUGS:
Lincare Contamination Leads To Investigation
To err may be human, but to track errors is the Food and Drug Administration. The FDA ... Read more
Lincare Contamination Leads To Investigation
To err may be human, but to track errors is the Food and Drug Administration. The FDA ... Read more
DRUG PRICING:
CMS Seeks Alternative To Inherent Reasonableness For Drugs
The trouble with bluffs is they wear off eventually. The Centers for Medicare & Medic... Read more
CMS Seeks Alternative To Inherent Reasonableness For Drugs
The trouble with bluffs is they wear off eventually. The Centers for Medicare & Medic... Read more
INDUSTRY NOTES:
Doctors Need To Ballast Hot-Air Cost Balloon
It's partly doctors' fault that medical costs are shooting up, says one influential doctor... Read more
Doctors Need To Ballast Hot-Air Cost Balloon
It's partly doctors' fault that medical costs are shooting up, says one influential doctor... Read more
CODING:
Surgically Remove Surgery From Aftercare Claims
Rehab practices may have welcomed the 30 new ICD-9 codes for postsurgical conditions intr... Read more
Surgically Remove Surgery From Aftercare Claims
Rehab practices may have welcomed the 30 new ICD-9 codes for postsurgical conditions intr... Read more
LEGISLATION:
Medicare Escapes Narrowly From Cuts
The Medicare program has made a narrow escape from huge budget cuts proposed by Republic... Read more
Medicare Escapes Narrowly From Cuts
The Medicare program has made a narrow escape from huge budget cuts proposed by Republic... Read more
BUNDLING:
Call Carriers To Avoid Bundling Shortfalls
If home medical equipment providers and Part B therapists furnish supplies or care to a ... Read more
Call Carriers To Avoid Bundling Shortfalls
If home medical equipment providers and Part B therapists furnish supplies or care to a ... Read more
PRACTICE EXPENSES:
Oncologists Hope To Avoid RVU Pie Fight
Can the Centers for Medicare & Medicaid Services fix reimbursement for cancer care wit... Read more
Oncologists Hope To Avoid RVU Pie Fight
Can the Centers for Medicare & Medicaid Services fix reimbursement for cancer care wit... Read more
LEGISLATION:
House Committee Aims To Insulate ALJs From CMS
The House Ways and Means Health Subcommittee March 20 passed Medicare regulatory and app... Read more
House Committee Aims To Insulate ALJs From CMS
The House Ways and Means Health Subcommittee March 20 passed Medicare regulatory and app... Read more
MEDICARE:
Bush Wants Physicians to Pay for Medicare Appeals, Claims Errors
Physicians who make a mistake while filling out a Medicare claim will pay a price under Pr... Read more
Bush Wants Physicians to Pay for Medicare Appeals, Claims Errors
Physicians who make a mistake while filling out a Medicare claim will pay a price under Pr... Read more
REIMBURSEMENT:
July Will Be Shakedown Time for Physicians
If you thought your nightmares were over now that Congress has rescued physician payments ... Read more
July Will Be Shakedown Time for Physicians
If you thought your nightmares were over now that Congress has rescued physician payments ... Read more
REIMBURSEMENT:
Medicare Physician Payments 'Adequate,' Says MedPAC
Physicians should enjoy the meager payment increase they wrangled from Congress last mon... Read more
Medicare Physician Payments 'Adequate,' Says MedPAC
Physicians should enjoy the meager payment increase they wrangled from Congress last mon... Read more
HIPAA:
HIPAA Trumps State Law, Court Rules
Physicians will still have to lay bare their patient records in legal proceedings in spite... Read more
HIPAA Trumps State Law, Court Rules
Physicians will still have to lay bare their patient records in legal proceedings in spite... Read more
MEDICAL REVIEW:
Don't Let Bogus Review Policies Fool You
Three Medicare carriers are pressuring physicians to choke off home care visits for patien... Read more
Don't Let Bogus Review Policies Fool You
Three Medicare carriers are pressuring physicians to choke off home care visits for patien... Read more
PHYSICIAN OFFICE LABS:
POLs' Supervision Puzzle Solved
Tired of playing guessing games when it comes to your physician office lab? CMS has trie... Read more
POLs' Supervision Puzzle Solved
Tired of playing guessing games when it comes to your physician office lab? CMS has trie... Read more
STUDIES & SURVEYS:
It's Only Wise to Apologize
Physicians might not be giving their patients the information or emotional support they ne... Read more
It's Only Wise to Apologize
Physicians might not be giving their patients the information or emotional support they ne... Read more
CODING:
NCCI Spells Extra Pain for Anesthesiologists
You may think you know all the ins and outs of the 19,000 edits in the latest National C... Read more
NCCI Spells Extra Pain for Anesthesiologists
You may think you know all the ins and outs of the 19,000 edits in the latest National C... Read more
FEDERAL INVESTIGATIONS:
Knee-Jerk Reactions Spell Serious Trouble
How many times did it happen when you were a kid? You faced a weekend's worth of pun... Read more
Knee-Jerk Reactions Spell Serious Trouble
How many times did it happen when you were a kid? You faced a weekend's worth of pun... Read more
FEDERAL INVESTIGATIONS:
9 Tips for Tackling an Investigation
If you find the feds at your door one false step can bring dire consequences. Now that yo... Read more
9 Tips for Tackling an Investigation
If you find the feds at your door one false step can bring dire consequences. Now that yo... Read more
DIAGNOSIS CODING:
Suppliers Fidget Over Added Digits
Durable medical equipment suppliers are preparing to play "guess the diagnosis code... Read more
Suppliers Fidget Over Added Digits
Durable medical equipment suppliers are preparing to play "guess the diagnosis code... Read more
DISEASE MANAGEMENT:
Medicare Tries Disease Management
Can the Medicare program get smart about managing chronic disease? Seems we're about to f... Read more
Medicare Tries Disease Management
Can the Medicare program get smart about managing chronic disease? Seems we're about to f... Read more
INDUSTRY NOTES:
Value Anesthetic Add-Ons Properly, CMS Tells Carriers
Carriers must recognize both base units and time units for primary and add-on anesthe... Read more
Value Anesthetic Add-Ons Properly, CMS Tells Carriers
Carriers must recognize both base units and time units for primary and add-on anesthe... Read more
EVALUATION & MANAGEMENT:
AHIMA and AHA Form E&M Panel
It's up to providers to prove once and for all that E/M doesn't stand for "extravagant and... Read more
AHIMA and AHA Form E&M Panel
It's up to providers to prove once and for all that E/M doesn't stand for "extravagant and... Read more
QUALITY OF CARE:
Physicians Poised for More CMS Scrutiny
Physicians might already feel that they're being monitored more than enough, but the feds ... Read more
Physicians Poised for More CMS Scrutiny
Physicians might already feel that they're being monitored more than enough, but the feds ... Read more
COURTS AND CASES:
Missed Deadline Costs Home Infusion Provider $185,000
A deadline is a deadline, and infusion provider Caremark Therapeutic Services wasn't able ... Read more
Missed Deadline Costs Home Infusion Provider $185,000
A deadline is a deadline, and infusion provider Caremark Therapeutic Services wasn't able ... Read more
FRAUD AND ABUSE:
Wake-Up Call for Telemarketing Suppliers
Disturbing people during dinner could be the least risky problem in telemarketing to home ... Read more
Wake-Up Call for Telemarketing Suppliers
Disturbing people during dinner could be the least risky problem in telemarketing to home ... Read more
What NOT to Do if the Feds Come Calling
Don't: Stand in the way - either literally or figuratively. "Never attempt to obstruct a... Read more
Don't: Stand in the way - either literally or figuratively. "Never attempt to obstruct a... Read more
MEDICAL DEVICES:
Medicare Won't Cover New E-Stim Code
The Centers for Medicare & Medicaid Services has established a HCPCS code for electr... Read more
Medicare Won't Cover New E-Stim Code
The Centers for Medicare & Medicaid Services has established a HCPCS code for electr... Read more
Available Years:
2003