Practice Management Alert
Fee Schedule News:
Prepare for 27 Percent Drop in Medicare Pay in 2012, If Congress Doesn't Step In
Some specialties will face even larger cuts if the physician 2012 Medicare fee schedule g... Read more
Prepare for 27 Percent Drop in Medicare Pay in 2012, If Congress Doesn't Step In
Some specialties will face even larger cuts if the physician 2012 Medicare fee schedule g... Read more
CPT® 2012 Primer:
Start Checking Time Documentation Before Reporting Initial Observation
Pay attention to inpatient guidelines for coding help.When CPT® 2011 debuted the sub... Read more
Start Checking Time Documentation Before Reporting Initial Observation
Pay attention to inpatient guidelines for coding help.When CPT® 2011 debuted the sub... Read more
CPT® 2012 Primer:
Rejoice the Addition of a New Flu Vaccine Code, New Preventive Services Modifier
Caveat: You're already using both the code and the modifier. You may be cheering the addit... Read more
Rejoice the Addition of a New Flu Vaccine Code, New Preventive Services Modifier
Caveat: You're already using both the code and the modifier. You may be cheering the addit... Read more
CPT® 2012 Primer:
Add 'Other Qualified Healthcare Professional' Clarification to Your CPT® Manual
Watch out: The new definition isn't all good news.If you've wondered what "other qualified... Read more
Add 'Other Qualified Healthcare Professional' Clarification to Your CPT® Manual
Watch out: The new definition isn't all good news.If you've wondered what "other qualified... Read more
Version 5010:
Avoid Countless Denials in the New Year -- Check to See If You're Prepared for the 5010 Conversion
You're not too late to prepare for the Jan. 1 deadline, experts say.The drop-dead date for... Read more
Avoid Countless Denials in the New Year -- Check to See If You're Prepared for the 5010 Conversion
You're not too late to prepare for the Jan. 1 deadline, experts say.The drop-dead date for... Read more
Check Your Version 5010 Status With This Handy Checklist
If you are counting on an extension of the Jan. 1, 2012 deadline for 5010 compliance "you ... Read more
If you are counting on an extension of the Jan. 1, 2012 deadline for 5010 compliance "you ... Read more
ABN Advice:
Incorporate New ABN To Collect For Non-Covered Services Going Forward
Even though there aren't substantial changes on the form, you need to make the switch.Now ... Read more
Incorporate New ABN To Collect For Non-Covered Services Going Forward
Even though there aren't substantial changes on the form, you need to make the switch.Now ... Read more
Collections Q&A:
Create a Solid Financial Policy That Tells Your Patients Exactly What You Expect
Get answers to your top financial policy questions from a billing expert.Having a financia... Read more
Create a Solid Financial Policy That Tells Your Patients Exactly What You Expect
Get answers to your top financial policy questions from a billing expert.Having a financia... Read more
Clip and Save:
Identify Financial Problems in Your Practice With Special Acronyms
Assigning payment and denial codes will help you track your claims success.If you don't kn... Read more
Identify Financial Problems in Your Practice With Special Acronyms
Assigning payment and denial codes will help you track your claims success.If you don't kn... Read more
Modifier Mythbuster -- Part 2:
Learn the Truth Behind 3 More Common Modifier 24 Myths
Hint: Know your payer's policies on billing complication treatment.To ensure payment for E... Read more
Learn the Truth Behind 3 More Common Modifier 24 Myths
Hint: Know your payer's policies on billing complication treatment.To ensure payment for E... Read more
You Be the Billing Expert:
Should Assistant Surgeon Billing Always Match Lead Surgeon's?
Question: I work in a general and laparoscopic surgeon's office. When he assists other sur... Read more
Should Assistant Surgeon Billing Always Match Lead Surgeon's?
Question: I work in a general and laparoscopic surgeon's office. When he assists other sur... Read more
Payer Updates:
Prepare for Version 5010 -- Even If Your Vendor Isn't Ready Yet
Plus, BCBS of North Carolina offers EMR support.If your practice is wondering what to do i... Read more
Prepare for Version 5010 -- Even If Your Vendor Isn't Ready Yet
Plus, BCBS of North Carolina offers EMR support.If your practice is wondering what to do i... Read more
Reader Question:
List As Many PQRS Codes As Needed
Question: Can we report more than one PQRS code measure on the same claim?Answer: Yes. You... Read more
List As Many PQRS Codes As Needed
Question: Can we report more than one PQRS code measure on the same claim?Answer: Yes. You... Read more
Reader Question:
Base E/M on Time for Counseling/Coordination Only
Question: If the physician documents: "Time spent in the evaluation of the patient with mo... Read more
Base E/M on Time for Counseling/Coordination Only
Question: If the physician documents: "Time spent in the evaluation of the patient with mo... Read more
Reader Question:
Know Your State Laws, Payer Rules Before Sending Patient to Collections
Question: I work in a physician's office handling the collection of past due copays, deduc... Read more
Know Your State Laws, Payer Rules Before Sending Patient to Collections
Question: I work in a physician's office handling the collection of past due copays, deduc... Read more
Workers' Compensation:
5 Guidelines Ease the Pain of Billing Workers' Compensation
If you don't get pertinent information before seeing the patient, expect trouble when you ... Read more
5 Guidelines Ease the Pain of Billing Workers' Compensation
If you don't get pertinent information before seeing the patient, expect trouble when you ... Read more
Modifier Mythbuster:
Clean Up Your Modifier 24 Claims By Learning the Truth About 5 Common Myths: Part 1
Focus on the physician's documentation, not the appointment book.If you want to ensure you... Read more
Clean Up Your Modifier 24 Claims By Learning the Truth About 5 Common Myths: Part 1
Focus on the physician's documentation, not the appointment book.If you want to ensure you... Read more
Clip and Save:
Take the 'Work' Out of Workers' Comp With This Sample Patient Intake Form
Easily capture all the information you'll need when it comes time to send in the claim.Hal... Read more
Take the 'Work' Out of Workers' Comp With This Sample Patient Intake Form
Easily capture all the information you'll need when it comes time to send in the claim.Hal... Read more
You Be the Billing Expert:
Uncomplicate Complicated Observation, Admit, Discharge Combo Billing
Question: I have trouble figuring out how to charge for a patient that was in observation,... Read more
Uncomplicate Complicated Observation, Admit, Discharge Combo Billing
Question: I have trouble figuring out how to charge for a patient that was in observation,... Read more
Payer Updates:
Get to Know Medicare's Teaching Physician Guidance
Plus, stick to standard CMS processes despite revalidation requests.Medicare's teaching ph... Read more
Get to Know Medicare's Teaching Physician Guidance
Plus, stick to standard CMS processes despite revalidation requests.Medicare's teaching ph... Read more
Reader Question:
Modifier 59: Ensure Separate Site or Service Before Appending
Question: I have an insurance company that is not paying for a code, stating it is bundled... Read more
Modifier 59: Ensure Separate Site or Service Before Appending
Question: I have an insurance company that is not paying for a code, stating it is bundled... Read more
Reader Question:
Apply Q5 for Vacation-Coverage Billing
Question: When one physician goes on vacation and a physician from the same group covers t... Read more
Apply Q5 for Vacation-Coverage Billing
Question: When one physician goes on vacation and a physician from the same group covers t... Read more
Reader Question:
Pay Attention to Supervision Differences for Therapeutic vs. Diagnostic
Question: I'd like to get verification on billing for allergy testing (95004), allergen pr... Read more
Pay Attention to Supervision Differences for Therapeutic vs. Diagnostic
Question: I'd like to get verification on billing for allergy testing (95004), allergen pr... Read more
Reimbursement Roundup:
Uncover Must-Know Appeals Changes Established By New Federal Law
Now's the time to find out how ERISA and PPACA impact your practice -- or you'll face... Read more
Uncover Must-Know Appeals Changes Established By New Federal Law
Now's the time to find out how ERISA and PPACA impact your practice -- or you'll face... Read more
Evaluation and Management:
Solidify Your Physical Examination Level Know-How With 4 FAQs
Beware the 1995 vs. 1997 guidelines pitfall by choosing just one at a time.When selecting ... Read more
Solidify Your Physical Examination Level Know-How With 4 FAQs
Beware the 1995 vs. 1997 guidelines pitfall by choosing just one at a time.When selecting ... Read more
Clip and Save:
Easily Choose Your Exam Level By Comparing Physician Documentation to This Handy Chart
Be sure you choose the guidelines that will be most advantageous to your coding.With two s... Read more
Easily Choose Your Exam Level By Comparing Physician Documentation to This Handy Chart
Be sure you choose the guidelines that will be most advantageous to your coding.With two s... Read more
You Be the Billing Expert:
Do You Need Two Tax IDs For Traveling Physicians?
Question: We have a dermatologist who wants to partner up with our otolaryngologist one da... Read more
Do You Need Two Tax IDs For Traveling Physicians?
Question: We have a dermatologist who wants to partner up with our otolaryngologist one da... Read more
Payer Updates:
Cigna, Humana Both See Good Second Quarter Numbers
Plus, read E/M billing clarification if you bill Medicare for teaching physician work.Acco... Read more
Cigna, Humana Both See Good Second Quarter Numbers
Plus, read E/M billing clarification if you bill Medicare for teaching physician work.Acco... Read more
Reader Question:
Save 99050 For Non-Advertised Hours
Question: I bill for a pediatrician who wants to use the 99050 add on code for our Saturda... Read more
Save 99050 For Non-Advertised Hours
Question: I bill for a pediatrician who wants to use the 99050 add on code for our Saturda... Read more
Reader Question:
99214: Give Credit For Time Spent With Patient
Question: Our physician spends a lot of time discussing treatment options, imaging results... Read more
99214: Give Credit For Time Spent With Patient
Question: Our physician spends a lot of time discussing treatment options, imaging results... Read more
Reader Question:
Skip 99360 When Billing to Medicare
Question: My doctors stand by for surgeons in some high-risk procedures/ cases. They want ... Read more
Skip 99360 When Billing to Medicare
Question: My doctors stand by for surgeons in some high-risk procedures/ cases. They want ... Read more
Reimbursement Roundup:
Don't Overlook Waiver Opportunities -- 3 Steps Ensure Compliance and Patient Payment
Hint: Documented financial hardship is your key.You've heard the mantra over and over ... Read more
Don't Overlook Waiver Opportunities -- 3 Steps Ensure Compliance and Patient Payment
Hint: Documented financial hardship is your key.You've heard the mantra over and over ... Read more
Version 5010 Update:
Watch Out for 5010 Glitch -- Don't Expect Your Vendor to Solve the Problem
Check on your address fields now -- before mistakes on your claim forms threaten to h... Read more
Watch Out for 5010 Glitch -- Don't Expect Your Vendor to Solve the Problem
Check on your address fields now -- before mistakes on your claim forms threaten to h... Read more
Clip and Save:
Avoid Legal and Financial Disaster By Getting Financial Hardship Agreements in Writing
Tailor these sample forms for your practice quickly and easily.Every practice has dealt wi... Read more
Avoid Legal and Financial Disaster By Getting Financial Hardship Agreements in Writing
Tailor these sample forms for your practice quickly and easily.Every practice has dealt wi... Read more
Key Version 5010 Reminders
Version 5010 will replace 4010/4010A1 for electronic transactions, including claims, eligi... Read more
Version 5010 will replace 4010/4010A1 for electronic transactions, including claims, eligi... Read more
You Be the Billing Expert:
Another ABN Update? Here's the Scoop
Question: I recently heard there is another ABN update that we need to comply with. We jus... Read more
Another ABN Update? Here's the Scoop
Question: I recently heard there is another ABN update that we need to comply with. We jus... Read more
Payer Updates:
AMA Report Card Ranks Payers, Finds 19.3 Percent Claims-Processing Error Rate
Plus, you received no payment at all on nearly 23 percent of claims submitted to commercia... Read more
AMA Report Card Ranks Payers, Finds 19.3 Percent Claims-Processing Error Rate
Plus, you received no payment at all on nearly 23 percent of claims submitted to commercia... Read more
Reader Question:
CMS Doesn't Currently Require Billing Certification
Question: I attended a conference recently and a speaker said that CMS is or will be requi... Read more
CMS Doesn't Currently Require Billing Certification
Question: I attended a conference recently and a speaker said that CMS is or will be requi... Read more
Reader Question:
Downcoding Is Just As Bad As Upcoding
Question: Texas Medicaid only will authorize a PET neck to mid thigh (78815) and will not ... Read more
Downcoding Is Just As Bad As Upcoding
Question: Texas Medicaid only will authorize a PET neck to mid thigh (78815) and will not ... Read more
Reimbursement Roundup:
Unfamiliar With ERISA? Let the Experts Get You Up to Speed With Answers to 5 Top Questions
If you don't learn the ERISA ropes, you could be losing out in the appeal stages.If you do... Read more
Unfamiliar With ERISA? Let the Experts Get You Up to Speed With Answers to 5 Top Questions
If you don't learn the ERISA ropes, you could be losing out in the appeal stages.If you do... Read more
Evaluation and Management:
99204-99205, 99214-99215: 3 PMFSH Tips Help You Start Billing Level Four and Five E/Ms
Tip: The physician doesn't have to be the one to document the history.If your aren't billi... Read more
99204-99205, 99214-99215: 3 PMFSH Tips Help You Start Billing Level Four and Five E/Ms
Tip: The physician doesn't have to be the one to document the history.If your aren't billi... Read more
Aspects of PFSH
Per CPT®, past medical, family and/or social history is divided into three subsectio... Read more
Per CPT®, past medical, family and/or social history is divided into three subsectio... Read more
Clip and Save:
Help Your Provider Capture PMFSH Data With This Handy Worksheet
Hint: You can have the patients document their own history as long as the physician review... Read more
Help Your Provider Capture PMFSH Data With This Handy Worksheet
Hint: You can have the patients document their own history as long as the physician review... Read more
You Be the Billing Expert:
Can Your Doc Offer Co-Pay Relief for Employees?
Question: My physicians are looking at giving employees a courtesy for their co-pays but w... Read more
Can Your Doc Offer Co-Pay Relief for Employees?
Question: My physicians are looking at giving employees a courtesy for their co-pays but w... Read more
Payer Updates:
Vermont Billers: Is a Single-Payer System In Your Future?
Plus, Medicare may go broke in 2024 according to report.On May 25, Peter Shumlin, governor... Read more
Vermont Billers: Is a Single-Payer System In Your Future?
Plus, Medicare may go broke in 2024 according to report.On May 25, Peter Shumlin, governor... Read more
Reader Question:
Go Ahead With Multiple Codes for Pediatric Immunization Billing
Question: I bill for a pediatric office and have a question about performing and reporting... Read more
Go Ahead With Multiple Codes for Pediatric Immunization Billing
Question: I bill for a pediatric office and have a question about performing and reporting... Read more
Reader Question:
Beware Modifier GZ Denials Starting July 1
Question: Which modifier applies when the physician performed a noncovered service for a M... Read more
Beware Modifier GZ Denials Starting July 1
Question: Which modifier applies when the physician performed a noncovered service for a M... Read more
Reader Question:
99058 May Be Your Answer For Emergency Walk-In Collections
Question: We recently hired a new physician who is questioning whether we can bill any ext... Read more
99058 May Be Your Answer For Emergency Walk-In Collections
Question: We recently hired a new physician who is questioning whether we can bill any ext... Read more
Version 5010:
Put Your Vendor to Version 5010 Test -- Sooner Rather Than Later
If your vendor isn't getting ready, it's time to consider a switch.You only have a little ... Read more
Put Your Vendor to Version 5010 Test -- Sooner Rather Than Later
If your vendor isn't getting ready, it's time to consider a switch.You only have a little ... Read more
Collections:
Tackle Non-Covered, Non-Medicare Services With ABN-Style Waiver
Skipping this step may lead to angry patients and lost reimbursement.You know that you nee... Read more
Tackle Non-Covered, Non-Medicare Services With ABN-Style Waiver
Skipping this step may lead to angry patients and lost reimbursement.You know that you nee... Read more
Clip and Save:
Ensure Patient Payment With a Solid Financial Responsibility Form
Tip: Be as specific as possible when filling out an ABN or waiver.If you aren't having you... Read more
Ensure Patient Payment With a Solid Financial Responsibility Form
Tip: Be as specific as possible when filling out an ABN or waiver.If you aren't having you... Read more
You Be the Billing Expert:
Timely Filing Rules May Depend on State Law
Question: One of our commercial payers has a timely filing rule that says we have to file ... Read more
Timely Filing Rules May Depend on State Law
Question: One of our commercial payers has a timely filing rule that says we have to file ... Read more
Payer Updates:
NJ payer settles secondary payer suit to the tune of $8 million
Plus, Cigna makes contracting faster and easier.Horizon Blue Cross Blue Shield (BCBS) of N... Read more
NJ payer settles secondary payer suit to the tune of $8 million
Plus, Cigna makes contracting faster and easier.Horizon Blue Cross Blue Shield (BCBS) of N... Read more
In other news
In late April, Cigna announced that it was introducing electronic contracting. According t... Read more
In late April, Cigna announced that it was introducing electronic contracting. According t... Read more
Reader Questions:
Follow Payer Policy Even If It Goes Against Coding Guidelines
Question: Our Medicaid carrier refuses to accept the new vaccination codes, but we know it... Read more
Follow Payer Policy Even If It Goes Against Coding Guidelines
Question: Our Medicaid carrier refuses to accept the new vaccination codes, but we know it... Read more
Reader Questions:
Base 99291-99292 on Care, Not Location
Question: After a patient with chest pain "coded" in the ER and was admitted to the ICU, o... Read more
Base 99291-99292 on Care, Not Location
Question: After a patient with chest pain "coded" in the ER and was admitted to the ICU, o... Read more
Reader Questions:
MRI-Safe Pacemaker Wasn't Part of New NCD
Question: Is it true that Medicare is now covering MRI scans for patients with the new MRI... Read more
MRI-Safe Pacemaker Wasn't Part of New NCD
Question: Is it true that Medicare is now covering MRI scans for patients with the new MRI... Read more
Version 5010:
Get Your Practice Ready For the Upcoming Version 5010 Challenges
The 2012 implementation deadline won't change, so now's the time to start preparing.Over t... Read more
Get Your Practice Ready For the Upcoming Version 5010 Challenges
The 2012 implementation deadline won't change, so now's the time to start preparing.Over t... Read more
Clip and Save:
Uncover Incident-to Billing Opportunities With This Handy Tool
Follow the flowchart to know when you can bill incident-to services and bring in 15 percen... Read more
Uncover Incident-to Billing Opportunities With This Handy Tool
Follow the flowchart to know when you can bill incident-to services and bring in 15 percen... Read more
Documentation Know-How:
Stay One Step Ahead of Your Payers By Ensuring Your Nurse's Notes Standup
Key: Your physician needs to review and sign any nurse's HPI notes.In these times of econo... Read more
Stay One Step Ahead of Your Payers By Ensuring Your Nurse's Notes Standup
Key: Your physician needs to review and sign any nurse's HPI notes.In these times of econo... Read more
You Be the Billing Expert:
Perfect Your Payer Fee Schedule
Question: We're getting ready to begin contract renewal negotiations with one of our payer... Read more
Perfect Your Payer Fee Schedule
Question: We're getting ready to begin contract renewal negotiations with one of our payer... Read more
Payer Updates:
Go Ahead and Skip Annual Wellness Visits If You Bill to WPS
If you've decided your practice doesn't have the resources to offer annual wellness visits... Read more
Go Ahead and Skip Annual Wellness Visits If You Bill to WPS
If you've decided your practice doesn't have the resources to offer annual wellness visits... Read more
Reader Questions:
Face-to-Face Counts in New vs. Established
Question: We saw a patient for pain injections earlier in the year and he is now coming in... Read more
Face-to-Face Counts in New vs. Established
Question: We saw a patient for pain injections earlier in the year and he is now coming in... Read more
Reader Questions:
Cookie Cutter Appeal Letters Won't Bring in the Cash
Question: After checking to be sure we haven't made a coding or billing entry error, our p... Read more
Cookie Cutter Appeal Letters Won't Bring in the Cash
Question: After checking to be sure we haven't made a coding or billing entry error, our p... Read more
Accounts Receivable:
Improving Your A/R Process With These 4 Tips Means Improving Your Collections
If you aren't following up on denials, you're leaving money on the table.The economic down... Read more
Improving Your A/R Process With These 4 Tips Means Improving Your Collections
If you aren't following up on denials, you're leaving money on the table.The economic down... Read more
Coding Corner:
Overcome Modifier 22 Mishaps With 3 Mythbusters
Making assumptions about automatically applying 22 will land you in OIG hot water.If you o... Read more
Overcome Modifier 22 Mishaps With 3 Mythbusters
Making assumptions about automatically applying 22 will land you in OIG hot water.If you o... Read more
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Set Clear No-Show Expectations With a Strong Letter to Patients
Use this sample letter to create one that works for your practice.Every practice has patie... Read more
Set Clear No-Show Expectations With a Strong Letter to Patients
Use this sample letter to create one that works for your practice.Every practice has patie... Read more
You Be the Billing Expert:
ABN for Low-Paying Drugs?
Question: As you are probably aware, Pfizer is increasing the cost of Prevnar by $5.00. Th... Read more
ABN for Low-Paying Drugs?
Question: As you are probably aware, Pfizer is increasing the cost of Prevnar by $5.00. Th... Read more
Payer Updates:
Skip 96402 For GnRH Injections in Noridian Patients
Plus, one MAC OKs RNs/LPNs providing annual wellness visits.If your practice sees patients... Read more
Skip 96402 For GnRH Injections in Noridian Patients
Plus, one MAC OKs RNs/LPNs providing annual wellness visits.If your practice sees patients... Read more
In other news
CMS staffers confirmed that MACs can determine whether they'll allow licensed practical nu... Read more
CMS staffers confirmed that MACs can determine whether they'll allow licensed practical nu... Read more
Reader Questions:
99221 + E/M Depends on Dates, Physician Presence
Question: Our physician saw a patient in the office, then admitted her to the hospital lat... Read more
99221 + E/M Depends on Dates, Physician Presence
Question: Our physician saw a patient in the office, then admitted her to the hospital lat... Read more
Reader Questions:
Skip No-Show Fees For Referrals
Question: Can a physician who refers a patient to another physician (specialist) charge hi... Read more
Skip No-Show Fees For Referrals
Question: Can a physician who refers a patient to another physician (specialist) charge hi... Read more
Reader Questions:
Don't Stick 25 on AWV
Question: We have several AWV charges (G0438) that have been denied because we attached a ... Read more
Don't Stick 25 on AWV
Question: We have several AWV charges (G0438) that have been denied because we attached a ... Read more
Case Study:
Keep Your Practice Out of Hot Water By Knowing When You Can -- and Can't -- Write Off a Patient Balance
Don't try to skirt around the system or you'll end up on the audit radar.Being a compassio... Read more
Keep Your Practice Out of Hot Water By Knowing When You Can -- and Can't -- Write Off a Patient Balance
Don't try to skirt around the system or you'll end up on the audit radar.Being a compassio... Read more
Reimbursement Roundup:
Modifier PT Helps Your Practice Capture Screening-Turned-Diagnostic Colonoscopy Pay
New modifier became effective Jan. 1 -- here's how you'll report it.The question of h... Read more
Modifier PT Helps Your Practice Capture Screening-Turned-Diagnostic Colonoscopy Pay
New modifier became effective Jan. 1 -- here's how you'll report it.The question of h... Read more
Clip And Save:
Avoid Lost Reimbursement By Capturing Every System Your Physician Checks With This Handy ROS Tool
Ensuring your physician's documentation captures every system he reviewed guarantees you p... Read more
Avoid Lost Reimbursement By Capturing Every System Your Physician Checks With This Handy ROS Tool
Ensuring your physician's documentation captures every system he reviewed guarantees you p... Read more
You Be the Billing Expert:
Discharge With No Face-to-Face
Question: A hospitalist dictates an initial hospital visit (admit) and a discharge within ... Read more
Discharge With No Face-to-Face
Question: A hospitalist dictates an initial hospital visit (admit) and a discharge within ... Read more
Payer Updates:
Horizon BCBS Pays Practices to be Proactive Rather Than Reactive
Plus, Massachusetts BCBS members may pay more for certain hospitals.Horizon Blue Cross Blu... Read more
Horizon BCBS Pays Practices to be Proactive Rather Than Reactive
Plus, Massachusetts BCBS members may pay more for certain hospitals.Horizon Blue Cross Blu... Read more
Reader Questions:
Check With Payer Before Billing 99307
Question: How do I bill if our physician went to the nursing home to see Medicare patients... Read more
Check With Payer Before Billing 99307
Question: How do I bill if our physician went to the nursing home to see Medicare patients... Read more
Reader Questions:
Update Your Software and Billing With 2011 CPT Modifier Changes
Question: We read lots of information about CPT 2011 code changes, but are there any modif... Read more
Update Your Software and Billing With 2011 CPT Modifier Changes
Question: We read lots of information about CPT 2011 code changes, but are there any modif... Read more
Reader Questions:
Prepare for Modifier SA Pay Reduction
Question: When the NP provides unsupervised services, I bill the codes under the nurse pra... Read more
Prepare for Modifier SA Pay Reduction
Question: When the NP provides unsupervised services, I bill the codes under the nurse pra... Read more
Reader Questions:
Watch Out for Payer-Specific Bundling Issues
Question: Sometimes I cannot find my two code pair in the CCI edits. How do I know which c... Read more
Watch Out for Payer-Specific Bundling Issues
Question: Sometimes I cannot find my two code pair in the CCI edits. How do I know which c... Read more
Reimbursement Roundup:
Clearly Outline Practice Expectations With No Show Letters and Fees
Check your payer rules before charging your patients. Every practice has the occasional p... Read more
Clearly Outline Practice Expectations With No Show Letters and Fees
Check your payer rules before charging your patients. Every practice has the occasional p... Read more
Red Flags Update:
Get the Scoop on the Latest Red Flags Rule Nuances
Clarification may mean your practice doesn't qualify as a 'creditor.' In a vote that came... Read more
Get the Scoop on the Latest Red Flags Rule Nuances
Clarification may mean your practice doesn't qualify as a 'creditor.' In a vote that came... Read more
Evaluation and Management:
Capture Level 4 and 5 Reimbursement By Honing Your ROS Skills
Ensure you have documentation of each system -- or prepare to bill a lesser service.... Read more
Capture Level 4 and 5 Reimbursement By Honing Your ROS Skills
Ensure you have documentation of each system -- or prepare to bill a lesser service.... Read more
You Be the Billing Expert:
Can You Skip Billing Post-Surgical Care?
Question: Our practice sees several patients who are on limited incomes. Our physician wo... Read more
Can You Skip Billing Post-Surgical Care?
Question: Our practice sees several patients who are on limited incomes. Our physician wo... Read more
Payer Updates:
CMS Waives Some 2011 Preventive Services Deductibles
Plus, BCBS in Illinois drops mental health pre-approval requirement. If your practice per... Read more
CMS Waives Some 2011 Preventive Services Deductibles
Plus, BCBS in Illinois drops mental health pre-approval requirement. If your practice per... Read more
In other news
If you're a mental health provider in Illinois, your Blue Cross Blue Shield patients have... Read more
If you're a mental health provider in Illinois, your Blue Cross Blue Shield patients have... Read more
Reader Questions:
New Year, New Insurance = New Verification
Question: How should I file a claim on a patient who has new coverage but has not receive... Read more
New Year, New Insurance = New Verification
Question: How should I file a claim on a patient who has new coverage but has not receive... Read more
Reader Questions:
Assign Specific DOS for 88321, 88323, 88325
Question: Our pathology lab performs outside consults on referred slides from other insti... Read more
Assign Specific DOS for 88321, 88323, 88325
Question: Our pathology lab performs outside consults on referred slides from other insti... Read more
Reader Questions:
Stick With Correct Code, Even if Non-covered
Question: Our Medicaid carrier included codes 64470-64476 on the 2009 physician fee sched... Read more
Stick With Correct Code, Even if Non-covered
Question: Our Medicaid carrier included codes 64470-64476 on the 2009 physician fee sched... Read more