Project reached 1.7 million people last year. The fanfare over the Senior Medicare Patrol has died down since the program’s debut in 1997, but the fraud-fighting initiative is still going strong — and racking up millions in related recoveries. In [...]
Extreme judgments may be a precursor of things to come. Time and again, fraudsters try to sidestep the feds’ wrath. And that’s why unlawful lab referrals and unnecessary testing remain a thorn in Medicare’s side. Last month’s junket of off-the-chart [...]
Fraud enforcements bring hefty fines - and prison. Unlawful lab referrals and unnecessary testing remain a thorn in Medicare's side. Last month's junket of extreme judgments may be a precursor of things to come. 3 for 3: A trio of [...]
MAC is initiating takebacks based on SMRC review. Medicare’s “probe and educate” claims reviews, focusing on certification including new face-to-face requirements, will hit episodes starting next month. You may get a hint of how the reviews will affect you by [...]
Even dislodging the foreign body deserves a code. The way your coding progresses in case of foreign body removal (FBR) will be dictated mainly by whether your gastroenterologist decides to removethe foreign body or simply moves it. Just follow these [...]
Being under so much medical review, home care and hospice providers are getting hit with overpayment letters and recoupments right and left. A new job aid from HHH MAC Palmetto GBA can help them through the process. Providers receive different [...]
930 (Foreign body on external eye) 930.1 (Corneal foreign body) 931 (Foreign body in the ear) 932 (Foreign body in the nose) 933.0 (Foreign body in pharynx) 933.1 (Foreign body in larynx) 934.0 (Foreign body in trachea) 934.1 (Foreign body [...]
Question: My physician has given me charges for a patient whom he saw in the ER for foreign body in esophagus. The ER visit led to an EGD with foreign body removal, which in turn led to a dilatation (CRE). [...]
Question:I'm not sure if the physician did an esophagogastroduodenoscopy (EGD) by removing several FBs from the esophagus, pushing them into the stomach. Does this qualify 43247 or should I bill 43215? Arizona SubscriberAnswer:This should qualify for a 43247 (Upper gastrointestinal [...]
In the stent coding example on p. 58, codes 93510, 93555, and 93556 all have both professional and technical components designated in the fee schedule. So when the procedure takes place in the facility setting the cardiologist should append modifier [...]
