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Part B Insider (Multispecialty) Coding Alert

Part B Errors:
Prevent MAC Ire With Complete Lab Requests
Plus: Don't skimp on E/M coding documentation. At your Part B practice, you likely submit... Read more
Balance Billing:
Feds Press on With Surprise Billing Regulatory Reform
Let CMS know how you feel about the changes by the Dec. 6 deadline. If your head is spinn... Read more
Part B Coding Coach:
Mythbuster: Shatter These 4 Myths on Common Winter Illness Dx Coding
Boost your coding skills with ICD-10 guidelines and instructions. With winter around the... Read more
Physician Notes:
Avoid Medicare Appeals Mix-Ups With MAC Advice
Tip: Ensure you're sending appeals to the right place. If your appeals seem to be stuck i... Read more
Reader Question:
Here’s the Scoop on Timely Filing Extensions
Question: At our practice, we are very careful to submit our Medicare fee-for-servic... Read more
CPT® 2022:
Check Out 99211 Revision, COVID-19 Codes
Tip: Many of the ‘new' codes aren't actually new. If you were concerned about handling... Read more
Documentation:
Utilize MDM Notes to Assist With Coding E/M Charts
Concise documentation is a boon to long-term treatment planning. If your outpatient E/M c... Read more
Part B Coding Coach:
Boost Nasal Hemorrhage Coding With These 5 Tips
Reminder: Patient's health status determines the code. Since CPT® contains five nasal he... Read more
Physician Notes:
Feds Mandate COVID Vaccines for Medicare-Certified Facilities
In an effort to curtail the Delta variant and reduce COVID spread, the feds have introduce... Read more
Physician Notes:
CMS Pushes MIPS Targeted Review Deadline Until November
If your Part B practice is still reviewing your updated Merit-Based Incentive Payment Syst... Read more
Physician Notes:
See the Latest Update on Medicare Payments for COVID Boosters
The verdict on COVID-19 booster shots is in. The feds have determined and authorized that ... Read more
ICD-10-CM:
Add SDoH Depth to Documentation With These New ICD-10 Codes
The 2022 revisions offer extra insight on Social Determinants of Health. On Oct. 1, you'l... Read more
Reimbursement:
CMS Forges Ahead With MVPs in 2022 Proposals
Prepare for traditional MIPS to go away by PY 2027. Over the past five years, the Qualit... Read more
Part B Coding Coach:
Boost Prolonged Services Savvy With These Expert Tips
Warning: Don't add prolonged service codes to service levels calculated by MDM. If you f... Read more
Targeted Probe And Educate:
Check Out the Latest Updates on TPE Medical Reviews
Tip: Check your individual jurisdiction's topics ASAP. Whether you are ready for Targete... Read more
Physician Notes:
Register the Latest At-Home Vaccination Payment Revisions
Understand the policy nuances for at-home vaccine administration. The feds aim to boost C... Read more
Reimbursement:
Feds Propose Big Conversion Factor Cut in 2022 MPFS
Hint: Past COVID legislation factors into policymaking. Recent proposals suggest you prob... Read more
Check Out 4 E/M Proposals in the MPFS
E/M services are the foundation of many Part B practices' bottom line. So, it shouldn't be... Read more
Telehealth Services:
Get Ready for More Telehealth Changes Next Year
Feds promote policies that increase healthcare equality. With the delta variant ramping u... Read more
ICD-10-CM Update:
Get the Scoop on COVID-19 Revisions Available Oct. 1
Plus: See new cough diagnosis code options. In its latest release, the Centers for Diseas... Read more
Part B Coding Coach:
Boost Anatomical Finger/Toe Modifier Mastery With These Tips
Offer comprehensive, specific notes on patients' injuries. If you get confused by the m... Read more
Physician Notes:
COVID PHE Gets Extended … Again
As the COVID-19 public health emergency (PHE) remains in full force, the Department of Hea... Read more
Physician Notes:
Use the Correct Credit Balance Form, MAC Urges
If you're returning a payment to Medicare, ensure you've got the updated version of the cr... Read more
Reader Questions:
Survey Exclusions List Before Hiring Staff
Question: Our small practice doesn't routinely check the HHS Office of Inspector General's... Read more
Enforcement:
Feds Target COVID Fraud in New Report
Caution: Expect scrutiny to only get more intense. If you thought the feds would put the ... Read more
Here’s a Breakdown of the Latest Enforcement Numbers
Compare and contrast the last two reporting period stats during COVID. Despite being in t... Read more
National Correct Coding Initiative:
Master NCCI PTP Edits With 4 Handy Tips
Caution: Take care when using a modifier to break an edit. When you submit myriad codes f... Read more
Part B Coding Coach:
Boost Non-Invasive Vascular Study Coding With This Insight
Tip: Review whether the code is bilateral or unilateral. If non-invasive vascular diagn... Read more
Clip And Save:
Pocket This POS Coding List
Tip: Check the small print on definitions to sidestep confusion. Correct place of service... Read more
Physician Notes:
E/M Upcoding Charge Garners Hefty Settlement for Physician Practice
A recent Department of Justice (DOJ) settlement shows that the feds take overbilling on E/... Read more
Physician Notes:
ACA Stands Strong in Latest Challenge in the Supreme Court
In its third legal go-round, Obamacare triumphs again after the U.S. Supreme Court confirm... Read more
Physician Notes:
CMS Bumps Up Payment for At-Home COVID Shots
You can expect a little more money in your pocket for at-home COVID-19 vaccination adminis... Read more
Modifiers:
Utilize 52, 53 for Stopped Surgery Claims
Caution: Know the particulars on modifier 53 to avoid denials. Occasionally, surgeons nee... Read more
Vendors:
Create a Template to Rate Your EHR Vendor
Hint: EHR companies continue to be on the OIG's watchlist. If you're considering switchi... Read more
Part B Coding Coach:
Bolster ED History Documentation With These 10 Tips
Ensure notes support the E/M level every time. If you're an emergency department coder, ... Read more
Physician Notes:
See New Reimbursement Details on COVID-19 Infusions
You can expect a little more money in your pocket when you administer monoclonal antibody ... Read more
Physician Notes:
OIG Homes In on PRF Payments in Latest Work Plan Update
Your Part B practice may have received HHS Provider Relief Fund (PRF) payments during the ... Read more
Medicare Provider Enrollment:
Feds Delay Affiliation Directives on Provider Apps
Don't anticipate the updated CMS-855 application until 2022 — or later. If sending Medi... Read more
Mythbusters:
Debunk 5 QPP Myths With These Facts
See which providers can receive MIPS special status. COVID-19 may have wreaked havoc on y... Read more
Documentation:
Perfect Part B Documentation With These Pointers
Tip: Know the Medicare rules on medical record amendments. One of the most important fact... Read more
Part B Coding Coach:
Tackle GI Imaging Services Coding With These Top Tips
Hint: Examine the specific area visualized before selecting a code. Most providers who pe... Read more
Physician Notes:
HHS Renewed the PHE for a 5th Time
On April 15, HHS Secretary Xavier Becerra extended the COVID-19 public health emergency (P... Read more
Physician Notes:
CMS Extends 2% Sequestration Suspension Until End of 2021
You have a little more time before you need to worry about the 2 percent sequestration pay... Read more
Physician Notes:
See Details on HHS’ Latest Round of Provider Relief Guidance Revisions
If you're planning on doing your Provider Relief Fund (PRF) reporting soon, you may want t... Read more
Reader Question:
Know the Settings Where Critical Care Can Be Reported
Question: Our physicians often perform critical care (99291-+99292) when they do rounds in... Read more
Covid-19 Relief:
See How New Funding Impacts Medicare Providers
Billions allotted to boost the public healthcare workforce. Medicare practices aren't the... Read more
Reimbursement:
Add 3 COVID-19-Related Updates to Your Policies
Good news: Vaccine administration rates just went up. As pandemic restrictions lift and y... Read more
Medicare Secondary Payer:
Sharpen MSP Skills With 10 Tough Questions
Tip: Know when Medicare is the primary payer. Whether you're an ace or a novice on Par... Read more
Part B Coding Coach:
Know the Facts on the Intersection of Same-Day E/M and Allergy Testing
Tip: Take advantage of CMS guidance and manuals. If you've read through Medicare guidanc... Read more
Physician Notes:
Weigh In on Future MIPS Measures
If you're interested in offering your opinion on Quality Payment Program (QPP) measures an... Read more
COVID-19 Vaccination:
Bolster Your Vaccination Rollout With 5 Top Tools
Tip: Review your state's online guidance, too. Whether you're part of the COVID-19 vacci... Read more
E/M 2021:
See How 2 New Prolonged Services Codes Diverge
Plus: Get the scoop on why CMS' adopted a new code in place of +99417. The E/M coding jo... Read more
HIPAA Security:
Set Up Stellar Remote Work Policies to Avoid HIPAA Fallout
Caution: Remote workers are hackers' dream targets, feds say. Despite the ramped-up COVI... Read more
Part B Coding Coach:
Tackle Shoulder Arthroscopy Coding With New Debridement Descriptors
Hint: CPT® 2021 revisions offer clarity. There are times when CPT® releases a new code... Read more
Reader Question:
Get the Facts on Medicare Overpayment Rebuttals
Question: Our practice just received a “demand letter” from our Medicare Administrativ... Read more
Physician Notes:
Review the Latest Medicare Advice on E/M Claims Review
Plus: Feds decide to reopen MIPS EUC app. If you were wondering whether the Centers for M... Read more
Physician Notes:
In other news …
In an effort to help clinicians combatting COVID-19, the Centers for Medicare & Medica... Read more
Compliance:
CERT Shows Part B Error Rate Spiked in FY 2020
Tip: Ensure documentation proves medical necessity. Even though the overall Medicare fee... Read more
Telehealth Services:
Master Telehealth Coding with 10 Facts from the Experts
See the latest advice from Part B MAC reps. If you're struggling to balance all the tele... Read more
Part B Telehealth Services Are on OIG’s Radar
Tip: Update your compliance plan ASAP. You now have another reason to clean up your teleh... Read more
Part B Coding Coach:
Use BMI and Overweight/Obesity Dx to Determine Correct ICD-10 Code
Check out four scenarios that highlight the coding nuances. When you enter a patient's ... Read more
Physician Notes:
Expect the PHE to Last All Year
Plus: Bank on regulatory relief to continue, too. With no end in sight, the feds anticipa... Read more
Part B Reimbursement:
Telehealth Continues to Dominate in 2021
Plus: Feds solidify E/M payment and documentation updates. In its latest reimbursement it... Read more
Pocket 5 Fee Schedule Highlights
MVP is finalized — with a 2022 start date now. There's no doubt that the calendar year ... Read more
Legislation:
COVID-19 Relief Offers Medicare Providers Much-Need Assistance
Hint: CY 2021 MPFS payments are impacted. After months of stalling, Congress finally pass... Read more
Part B Coding Coach:
Pain Management: Boost TPI, CT Shot Prowess With Expert Insight
Tip: Base TPI coding on muscles injected, rather than the number of shots. Deciphering t... Read more
Reader Question:
Check DOS for Late December/Early January E/M Visits
Question: An established patient reports to the provider for an office E/M service. The pr... Read more
Physician Notes:
Prepare Staff for COVID-19 Vaccine Questions
If your phone is ringing off the hook with questions about COVID-19 vaccines, the Centers ... Read more
Physician Notes:
See Deadline Extension for MIPS 2020 Hardship Apps
If your Part B practice suffered some setbacks last year and you need to submit a Merit-Ba... Read more
Physician Notes:
FDA Updates Device Shortage List and FAQ
In an effort to be more transparent, the Food and Drug Administration (FDA) revised its de... Read more
Improper Payment Rate:
‘Corrective Actions’ Decrease Overall Rates
Hint: Inadequate documentation remains a problem. If you've been waiting patiently for Me... Read more
Compliance:
Stark Update Offers Providers a Sleigh Full of Surprises
Hint: New exceptions and definitions clear up confusion. Since the onslaught of the pande... Read more
COVID-19:
Get the Facts on Part B Payment Rates for Future Vaccines
Add all the cost-sharing particulars to your COVID-19 checklist. If your head is spinning... Read more
Part B Coding Coach:
Add This E/M Overview to Your Resources
Tip: You've got one less code to worry about now. With 2020 behind us, it's a good time... Read more
Reader Question:
Understand HIPAA Nuances on Electronic Signatures
Question: With the pandemic still impacting our daily schedule, we continue to see a major... Read more
Physician Notes:
Care Compare Is Up and Running
Hint: Quality monitoring remains status quo. Whether or not you were ready to move on, th... Read more
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