Part B Insider (Multispecialty) Coding Alert
Part B Reimbursement:
Expect Reduced Burdens, Cutbacks, and Delays, MPFS Final Rule Suggests
CMS spotlights telehealth, diabetes prevention, and quality adjustments in 2018. The twin... Read more
Expect Reduced Burdens, Cutbacks, and Delays, MPFS Final Rule Suggests
CMS spotlights telehealth, diabetes prevention, and quality adjustments in 2018. The twin... Read more
Find Out If Your Part B Pay Will Increase in 2018
Don't expect the conversion factor's slight bump to make much of a difference next year. ... Read more
Don't expect the conversion factor's slight bump to make much of a difference next year. ... Read more
E/M Coding:
Know These E/M Rules to Avoid Fracture Care Fails
Hint: Review E/M modifier usage and append if necessary. When you provide fracture care f... Read more
Know These E/M Rules to Avoid Fracture Care Fails
Hint: Review E/M modifier usage and append if necessary. When you provide fracture care f... Read more
Part B Coding Coach:
Get a Grip on New Category III Code Options for 2018 Claims
Tip: Review the CPT® Integumentary section for scar procedure differentiation. An emergi... Read more
Get a Grip on New Category III Code Options for 2018 Claims
Tip: Review the CPT® Integumentary section for scar procedure differentiation. An emergi... Read more
Physician Notes:
Review New Medicare Appeals Options
If you rarely need appeals advice, that's a good thing. It means your claims are good-to-g... Read more
Review New Medicare Appeals Options
If you rarely need appeals advice, that's a good thing. It means your claims are good-to-g... Read more
Physician Notes:
Update Your Data Use Agreements Now, CMS Advises
Nothing is more important than the security of protected health information, not only for ... Read more
Update Your Data Use Agreements Now, CMS Advises
Nothing is more important than the security of protected health information, not only for ... Read more
Physician Notes:
Stay Abreast of Updates and Advice on the Medicare Card Number Transition
With the start date for the Medicare number transition less than six months away, many pra... Read more
Stay Abreast of Updates and Advice on the Medicare Card Number Transition
With the start date for the Medicare number transition less than six months away, many pra... Read more
Medical Review:
Fix Claims Issues to Prevent TPE Scrutiny
Targeted Probe and Educate audits are now in full swing. If Medicare Part B forms and doc... Read more
Fix Claims Issues to Prevent TPE Scrutiny
Targeted Probe and Educate audits are now in full swing. If Medicare Part B forms and doc... Read more
Part B Billing:
Review ADRs and Correct Problems ... or Else, CMS Warns
New Targeted Probe and Educate revamp punishes wrongdoers. If you've been lax in your res... Read more
Review ADRs and Correct Problems ... or Else, CMS Warns
New Targeted Probe and Educate revamp punishes wrongdoers. If you've been lax in your res... Read more
CPT® 2018:
Get Ready for These 5 Major Coding Changes Effective Jan. 1
Be aware of observation code updates because the language is confusing. Don't think you'r... Read more
Get Ready for These 5 Major Coding Changes Effective Jan. 1
Be aware of observation code updates because the language is confusing. Don't think you'r... Read more
Part B Coding Coach:
ICD-10: Perfect Your Eye Care Coding with 5 Expert Tips
Pinpoint specifics with new diagnosis code options for ophthalmology. The new ICD-10 code... Read more
ICD-10: Perfect Your Eye Care Coding with 5 Expert Tips
Pinpoint specifics with new diagnosis code options for ophthalmology. The new ICD-10 code... Read more
Physician Notes:
Upcoding and False Claims Continue to Garner Big Penalties from the OIG
Plus: The QRUR review period is "informally open," according to CMS. Upcoding is a focus ... Read more
Upcoding and False Claims Continue to Garner Big Penalties from the OIG
Plus: The QRUR review period is "informally open," according to CMS. Upcoding is a focus ... Read more
Correct Coding Initiative:
Keep Abreast of the NCCI Edits for Bundled Surgical Procedures
Modifier 59 often factors into the claims equation. Coders consider the National Correct ... Read more
Keep Abreast of the NCCI Edits for Bundled Surgical Procedures
Modifier 59 often factors into the claims equation. Coders consider the National Correct ... Read more
MACRA:
Are You Eligible to Report Measures in a Virtual Group? Find Out Here
If reporting under MIPS has you worried, a Virtual Group might be for you. Medicare Part ... Read more
Are You Eligible to Report Measures in a Virtual Group? Find Out Here
If reporting under MIPS has you worried, a Virtual Group might be for you. Medicare Part ... Read more
Compliance:
Dodge These Perennial E/M Issues Found in the CERT Report
Watch your "medical decision making" documentation to keep claims on track. If evaluation... Read more
Dodge These Perennial E/M Issues Found in the CERT Report
Watch your "medical decision making" documentation to keep claims on track. If evaluation... Read more
Part B Coding Coach:
Master Abdominal Pain Coding with These 4 Steps
Substantiate symptoms and signs of stomach suffering with this guide. What happens when a... Read more
Master Abdominal Pain Coding with These 4 Steps
Substantiate symptoms and signs of stomach suffering with this guide. What happens when a... Read more
Physician Notes:
Mark Your Calendars for NPI Requirement Date
Plus: The ICD-10 mapping tool is going away soon. If you've lagged behind on using NPIs f... Read more
Mark Your Calendars for NPI Requirement Date
Plus: The ICD-10 mapping tool is going away soon. If you've lagged behind on using NPIs f... Read more
Part B Payment:
CMS Eases Up on Providers Weary of Medicare's Paper Trail in 2018
Telehealth, MACRA, and E/M weigh heavily in the 2018 MPFS proposals. CMS continues its fo... Read more
CMS Eases Up on Providers Weary of Medicare's Paper Trail in 2018
Telehealth, MACRA, and E/M weigh heavily in the 2018 MPFS proposals. CMS continues its fo... Read more
Part B Statistics:
Will Your Medicare Payments Go Up for CY 2018? Find Out Here
Reporting burdens may be eased, but don't expect your pay to go up. Providers may see MAC... Read more
Will Your Medicare Payments Go Up for CY 2018? Find Out Here
Reporting burdens may be eased, but don't expect your pay to go up. Providers may see MAC... Read more
Modifiers:
Anticipate Pay Cuts for Modifier 25 Claims, Private Payer Says
One insurer is slashing modifier 25 claims in half — others may follow. Many practi... Read more
Anticipate Pay Cuts for Modifier 25 Claims, Private Payer Says
One insurer is slashing modifier 25 claims in half — others may follow. Many practi... Read more
Part B Coding Coach:
Master Laceration Repair in the ED with These 3 Coding FAQs
Know when to add repair lengths together — and when you shouldn’t. Laceration... Read more
Master Laceration Repair in the ED with These 3 Coding FAQs
Know when to add repair lengths together — and when you shouldn’t. Laceration... Read more
Physician Notes:
Take a Look at AHIMA Guidance to Ease Patients' Requests for PHI
Plus: Educate yourself on 3 CMS-855 form updates for 2018. Patients armed with their heal... Read more
Take a Look at AHIMA Guidance to Ease Patients' Requests for PHI
Plus: Educate yourself on 3 CMS-855 form updates for 2018. Patients armed with their heal... Read more
MACRA:
Prepare Now for Possible MIPS Low-Volume Threshold Changes in 2018 and Beyond
Small-Practice Part B providers find relief under the QPP proposed rule. If you’ve ... Read more
Prepare Now for Possible MIPS Low-Volume Threshold Changes in 2018 and Beyond
Small-Practice Part B providers find relief under the QPP proposed rule. If you’ve ... Read more
Check Out Other Ways the QPP Proposed Rule Might Impact Your Pay
The eased CEHRT requirements give Part B providers more time to adapt and adopt. CMS unde... Read more
The eased CEHRT requirements give Part B providers more time to adapt and adopt. CMS unde... Read more
E/M Coding:
Overcome 99211 Confusion with These 3 Tips
Tip: You can use 99211 for a Rx pickup for specific cases. Medicare Part B providers use ... Read more
Overcome 99211 Confusion with These 3 Tips
Tip: You can use 99211 for a Rx pickup for specific cases. Medicare Part B providers use ... Read more
Compliance:
What's Under the OIG Microscope Right Now? Find Out
A motorcycle gang’s “pill mill” just got schooled by the federal watchdo... Read more
What's Under the OIG Microscope Right Now? Find Out
A motorcycle gang’s “pill mill” just got schooled by the federal watchdo... Read more
Part B Coding Coach:
New Proposed ICD-10-CM Codes May Impact Gastroenterology in October
Watch for changes to diverticulitis, appendicitis, and cholelithiasis. Diverticulitis cod... Read more
New Proposed ICD-10-CM Codes May Impact Gastroenterology in October
Watch for changes to diverticulitis, appendicitis, and cholelithiasis. Diverticulitis cod... Read more
Physician Notes:
Focus on Medical Necessity to Avoid Upcoding Issues, DOJ Case Suggests
Hint: Your documentation dictates your coding. Upcoding — year after year, it remai... Read more
Focus on Medical Necessity to Avoid Upcoding Issues, DOJ Case Suggests
Hint: Your documentation dictates your coding. Upcoding — year after year, it remai... Read more
Compliance:
Take a Look at What's on the OIG Hit List
Home health, hospice, and children’s health continue to be issues for the HHS. Even... Read more
Take a Look at What's on the OIG Hit List
Home health, hospice, and children’s health continue to be issues for the HHS. Even... Read more
Part B Statistics:
Measure Your Physical Therapy Claims Against Your Peers
Hint: Clear and concise documentation alleviates many coding issues. Ever wonder how your... Read more
Measure Your Physical Therapy Claims Against Your Peers
Hint: Clear and concise documentation alleviates many coding issues. Ever wonder how your... Read more
Clip And Save:
Get the Lowdown on New Updates to ICD-10
Be ahead of the curve for FY 2018 with insight into over 6,000 new, revised, and deleted c... Read more
Get the Lowdown on New Updates to ICD-10
Be ahead of the curve for FY 2018 with insight into over 6,000 new, revised, and deleted c... Read more
Part B Coding Coach:
Master Lesion Destruction Claims with Answers to 3 Common Myths
Hint: Utilize the CPT® documentation to code without error. Are you in the know when ... Read more
Master Lesion Destruction Claims with Answers to 3 Common Myths
Hint: Utilize the CPT® documentation to code without error. Are you in the know when ... Read more
Physician Notes:
Ready Your Practice for Next Year's SSN-Free Medicare Card Transition
Medicare cards are getting a makeover in 2018. With a start date sometime in April of 2018... Read more
Ready Your Practice for Next Year's SSN-Free Medicare Card Transition
Medicare cards are getting a makeover in 2018. With a start date sometime in April of 2018... Read more
RAC Audits:
Focus on AWV Basics or Risk Your Claims Coming Under Review
Don’t confuse a “Welcome to Medicare” visit with an annual wellness visi... Read more
Focus on AWV Basics or Risk Your Claims Coming Under Review
Don’t confuse a “Welcome to Medicare” visit with an annual wellness visi... Read more
Master a RAC Audit with Advance Planning
Tip: Keep abreast of MAC and federal changes to avoid confusion. Preparation is the key t... Read more
Tip: Keep abreast of MAC and federal changes to avoid confusion. Preparation is the key t... Read more
Clip And Save:
Keep Your Practice Compliant with This Top 5 List of HIPAA Fails
Don’t drop the ball on network monitoring — that’s how the hackers sneak... Read more
Keep Your Practice Compliant with This Top 5 List of HIPAA Fails
Don’t drop the ball on network monitoring — that’s how the hackers sneak... Read more
MACRA:
Worried Your MIPS Invite Got Lost in the Mail? Check Online and Verify Your Status
New CMS tool lets anxious Part B providers see if they are required to report for 2017. S... Read more
Worried Your MIPS Invite Got Lost in the Mail? Check Online and Verify Your Status
New CMS tool lets anxious Part B providers see if they are required to report for 2017. S... Read more
Part B Coding Coach:
Master Mammography Coding with This Expert Guidance
Tip: Use a modifier when a screening turns diagnostic. Not every mammography case is clea... Read more
Master Mammography Coding with This Expert Guidance
Tip: Use a modifier when a screening turns diagnostic. Not every mammography case is clea... Read more
Physician Notes:
Review New Smart Form Guidance from Cahaba
Plus: A Chicago physician is looking at possibly 120 years for Medicare fraud. If the bar... Read more
Review New Smart Form Guidance from Cahaba
Plus: A Chicago physician is looking at possibly 120 years for Medicare fraud. If the bar... Read more
MACRA:
Are You on Board with New QPP Measures Yet? Get The Details Here
Most providers are in the dark about the how to report under MACRA. If new value-based, q... Read more
Are You on Board with New QPP Measures Yet? Get The Details Here
Most providers are in the dark about the how to report under MACRA. If new value-based, q... Read more
E/M Coding:
Master PFSH with These 6 Expert Tips
Hint: Concise documentation can make a world of difference. It’s vital that you und... Read more
Master PFSH with These 6 Expert Tips
Hint: Concise documentation can make a world of difference. It’s vital that you und... Read more
Revenue Booster:
Make Accurate Coding a Priority and Boost Your Profits
Use this expert’s reference guide to improve your cash flow. If you’re not go... Read more
Make Accurate Coding a Priority and Boost Your Profits
Use this expert’s reference guide to improve your cash flow. If you’re not go... Read more
Part B Coding Coach:
Understand the Nuances of CCI Edits to Cardiology
Use this primer to prepare for what’s ahead. CMS initiated the Correct Coding Initi... Read more
Understand the Nuances of CCI Edits to Cardiology
Use this primer to prepare for what’s ahead. CMS initiated the Correct Coding Initi... Read more
Physician Notes:
Be Aware of Changes to Prolonged Service Time Limits
In November, CMS offered new E/M options for prolonged services reportable in 2017. In rec... Read more
Be Aware of Changes to Prolonged Service Time Limits
In November, CMS offered new E/M options for prolonged services reportable in 2017. In rec... Read more
Compliance:
Insider Threats: Be Mindful As You Implement Your Practice HIPAA Plan
Hint: Change your passwords often to decrease breach opportunities. Yes, you must protect... Read more
Insider Threats: Be Mindful As You Implement Your Practice HIPAA Plan
Hint: Change your passwords often to decrease breach opportunities. Yes, you must protect... Read more
Benchmarking:
Why Are Your Hospital H&P Claims Denied? Level 3 E/M Codes Might Be to Blame
Keep in mind that discharges and subsequent hospital visits cannot fall on the same day. ... Read more
Why Are Your Hospital H&P Claims Denied? Level 3 E/M Codes Might Be to Blame
Keep in mind that discharges and subsequent hospital visits cannot fall on the same day. ... Read more
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Get the Scoop on 2017 Telehealth Updates with This Handy Rundown
Place of service is key to avoid denials. New advancements in telehealth technologies off... Read more
Get the Scoop on 2017 Telehealth Updates with This Handy Rundown
Place of service is key to avoid denials. New advancements in telehealth technologies off... Read more
Part B Coding Coach:
Boost Sigmoidoscopy Profits By Differentiating Payers and Purpose
Make your medical documentation clear to avoid confusion on services rendered. You could ... Read more
Boost Sigmoidoscopy Profits By Differentiating Payers and Purpose
Make your medical documentation clear to avoid confusion on services rendered. You could ... Read more
Physician Notes:
House Offers Up Its Answer to the ACA Repeal
AMA and others find fault with the American Health Care Act. As the Affordable Care Act c... Read more
House Offers Up Its Answer to the ACA Repeal
AMA and others find fault with the American Health Care Act. As the Affordable Care Act c... Read more
Part B Payment:
Minimized Measures Make Reporting Under MIPS a Breeze in 2017
Look at these small practice tips to overcome MACRA overload. It’s MACRA crunch tim... Read more
Minimized Measures Make Reporting Under MIPS a Breeze in 2017
Look at these small practice tips to overcome MACRA overload. It’s MACRA crunch tim... Read more
Compliance:
Expect to Be on the OIG's Radar If You Rely Heavily on Upcoding to Make Ends Meet
Strong documentation will help with damage control and the FCA. When it comes to coding a... Read more
Expect to Be on the OIG's Radar If You Rely Heavily on Upcoding to Make Ends Meet
Strong documentation will help with damage control and the FCA. When it comes to coding a... Read more
Unbundling and Double-Billing Go Hand-In-Hand with Upcoding
Look to modifiers to avoid claims denials in these cases. Coordinated care is at the hear... Read more
Look to modifiers to avoid claims denials in these cases. Coordinated care is at the hear... Read more
Part B Coding Coach:
Know These Handy Add-Ons to Master Prolonged Services Coding
Time factors greatly in the new prolonged services options. Reporting prolonged ser... Read more
Know These Handy Add-Ons to Master Prolonged Services Coding
Time factors greatly in the new prolonged services options. Reporting prolonged ser... Read more
Physician Notes:
Manage Your Health IT Risk Or Face the Consequences, OCR Says
Plus: Meaningful Use is set to sail away forever, so attest while you can. Encryption con... Read more
Manage Your Health IT Risk Or Face the Consequences, OCR Says
Plus: Meaningful Use is set to sail away forever, so attest while you can. Encryption con... Read more
Compliance:
Practices Short Themselves Out of $342 Million, Downcoded E/M Visits to Blame
Documentation woes continue to be a major problem for practices, CERT results reveal. ... Read more
Practices Short Themselves Out of $342 Million, Downcoded E/M Visits to Blame
Documentation woes continue to be a major problem for practices, CERT results reveal. ... Read more
E/M Coding:
Confront MDM & Medical Necessity Head On With This E/M Coding Primer
Strong documentation supports medically necessary care — it’s just that simp... Read more
Confront MDM & Medical Necessity Head On With This E/M Coding Primer
Strong documentation supports medically necessary care — it’s just that simp... Read more
MACRA:
HCPCS Modifiers May Be at the Center of Coding for MACRA
Take a look at the MIPS cost categories for patient relationship coding under CMS review... Read more
HCPCS Modifiers May Be at the Center of Coding for MACRA
Take a look at the MIPS cost categories for patient relationship coding under CMS review... Read more
Revenue Booster:
Don't Let Your 2017 EHR Implementation Sink Your Profits
Use this expert advice to make the most of your new practice technology. Clunky system... Read more
Don't Let Your 2017 EHR Implementation Sink Your Profits
Use this expert advice to make the most of your new practice technology. Clunky system... Read more
Part B Coding Coach:
This Angioplasty Q&A Makes Tackling New CPT® 2017 Codes 37246-37249 A Breeze
Uncover the secret to know which vessels go with which codes. If you’ve already... Read more
This Angioplasty Q&A Makes Tackling New CPT® 2017 Codes 37246-37249 A Breeze
Uncover the secret to know which vessels go with which codes. If you’ve already... Read more
Physician Notes:
ICD-10 Glitch Causes CMS to Slacken PQRS Requirements
The transition from ICD-9 to ICD-10 has had its fair share of ups and downs. But, a rece... Read more
ICD-10 Glitch Causes CMS to Slacken PQRS Requirements
The transition from ICD-9 to ICD-10 has had its fair share of ups and downs. But, a rece... Read more
Modifiers:
Use G Modifiers to Represent ABN Situation
Medicare uses G modifiers to specify why practice issues ABN. Patients that report to ... Read more
Use G Modifiers to Represent ABN Situation
Medicare uses G modifiers to specify why practice issues ABN. Patients that report to ... Read more
Compliance:
OIG Ups the Ante on Holiday Gift Giving
New giving guideline offers options but also brings a heftier fine. The old saying goe... Read more
OIG Ups the Ante on Holiday Gift Giving
New giving guideline offers options but also brings a heftier fine. The old saying goe... Read more
Coding Quiz:
Take a Look at These 5 Coding Examples to Help You in the New Year
Here’s a quick question-and-answer to five common coding worries by specialty. ... Read more
Take a Look at These 5 Coding Examples to Help You in the New Year
Here’s a quick question-and-answer to five common coding worries by specialty. ... Read more
Supply Billing:
Boost Your Bottom Line With 4 Quick Supply-Billing Tips
Remember: 99070 is not a one-size-fits-all materials code. When it comes to billing fo... Read more
Boost Your Bottom Line With 4 Quick Supply-Billing Tips
Remember: 99070 is not a one-size-fits-all materials code. When it comes to billing fo... Read more
Part B Coding Coach:
ICD-10-CM Update: Zero In On Abdominal Pain Coding With Options from R10 Category
Choose carefully between R10.84 and R10.817 for generalized pain vs. tenderness. There... Read more
ICD-10-CM Update: Zero In On Abdominal Pain Coding With Options from R10 Category
Choose carefully between R10.84 and R10.817 for generalized pain vs. tenderness. There... Read more
Industry Notes:
Fraudulent Cybersecurity Firm Masquerades As the OCR in Phishing Scam
Falling in line with cyber Monday’s tradition of glitches and deceit, a cybersecur... Read more
Fraudulent Cybersecurity Firm Masquerades As the OCR in Phishing Scam
Falling in line with cyber Monday’s tradition of glitches and deceit, a cybersecur... Read more