Append modifier 47 to a procedure when the surgeon who performs the procedure also administers the regional or general anesthesia.
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Question: I’m trying to navigate situations in which a patient is a Medicare beneficiary but also has other insurance. I know this situation is called Medicare Secondary Payer (MSP). What are the different types of MSPs? Washington Subscriber Answer: You [...]
Applying modifiers correctly is the key to successful payment on this claim. Surgeries for ingrown toenails are a common occurrence that you’ll likely come across in your podiatry coding. These procedures are so prevalent that many podiatrists carry out around [...]
Hint: Modifiers can show payers which anesthesia professional performed a service. Getting paid correctly with anesthesia modifiers may not be as easy as you think! If you’ve read the Codify articles for filing clean certified registered nurse anesthetist (CRNA) claims, [...]
Question: We need help understanding minutes to units conversion. If payers want total minutes in the units field on the CMS 1500, how do you convert the base units? Would you assume one unit equals 15 minutes? Ohio Subscriber Answer: It’s important [...]
Hint: It isn’t just California and Texas. You can bet your law- and policy-makers will be poring over the statistics offered by the Medicare Payment Advisory Commission in its latest report to Congress — and that means you should too. [...]
Plus: Stay tuned for missing CAHPS data in preview reports. Failing to comply with a recently finalized Medicare requirement could put a big old target on your agency’s back when it comes to fraud and abuse scrutiny. The Centers for [...]
Lawsuits, fee changes, and proposals abound. Since its inception, turmoil has surrounded the No Surprises Act — and that doesn’t seem to be going away any time soon. Read on for the latest changes on the feds’ surprise billing regulations. [...]
Brookdale Senior Living Inc. has sold “its remaining 20 percent equity interest in its Health Care Services unconsolidated venture and received aggregate proceeds of approximately $27 million in connection with the transaction,” the Nashville-based senior living operator says in a [...]
Also: check out the new guidance for reporting COPD. Last month, we covered the office/outpatient time changes you can expect in 2024, but can you recall the new ICD-10 codes that took effect Apr. 1, 2023? How about the ones [...]
Nonhospice spending gets another go-round. Hospices may feel they’ve been examined six ways to Sunday already, but an influential advisory body to Congress is planning to pile on yet more scrutiny. “Hospice remains a very important, although sometimes controversial, aspect [...]
