Question: Our lab is getting denials for testing for GI pathogens such as one of the 87505 family codes. What could be the reason for the denials? Codify Subscriber Answer: Many insurers have coverage policies for 87505 (Infectious agent detection by nucleic [...]
Question: A patient underwent a bilateral mastectomy after having breast cancer of the left upper inner breast, which was coded to C50.212. The patient is now on adjuvant hormonal therapy (Tamoxifen) for five years. Is the specific location of the breast [...]
The crackdown on overtime pay violations continues. Case #1: The U.S. Department of Labor has recovered nearly $138,000 in back wages and damages from a Lubbock, Texas home care provider. Lubbock Essential Home Health Care Inc., operating as Essential Home [...]
SNFs need to be extra careful about penalized noncompliance. The Centers for Medicare & Medicaid Services (CMS) has released updated specifics on the violation fines associated with civil monetary penalties (CMPs). Remember, the CMP program is designed to penalize providers, [...]
Increase was effective Nov. 15. As practice costs continue to rise due to inflation, you may want to add another line item to your budget — because civil monetary penalty (CMP) amounts for HIPAA breaches just went up. Update: On [...]
Warning: HHS’ penalty numbers went into effect on Nov. 15. If the sting of inflation is hurting on your practice budget, we’ve got more bad news. The feds just upped the HIPAA penalty amounts — and the numbers aren’t pretty. [...]
Entyvio infusions are common at GI practices, but remain a coding enigma to many people. When you think about your most-billed codes, your mind probably goes to E/M services and colonoscopies, but the service that ranked second among gastroenterologists’ most-reported [...]
Get the hang of all the new ICD-10-CM changes now, just in time for October. ICD-10-CM has a broad range of sweeping changes affecting neoplasms of the eyelid and surrounding structures. The updated ICD-10-CM index and tabular will break down [...]
Caveat: Your provider will still need detailed documentation for you to code correctly. The newest changes to ICD-10 go into effect on Oct. 1, and you won’t want to miss some of the updates. Of the hundreds of additions, quite [...]
Hint: You’ll have lots more urethral stricture options. The next round of ICD-10-CM changes won’t go into effect until Oct. 1, but CMS has released information on new, revised, and deleted codes for the next year. Changes applicable to urology [...]
