Correct Coding Initiative: ‘Mutually Exclusive’ and ‘Bundled’ Defined

Decipher what column 1/column 2 means in this neurosurgery bundle example.

Question: Would you explain what the differences are between mutually exclusive and “column 1/column 2″ edits that come from the Correct Coding Initiative (CCI)?

Florida Subscriber

Answer: Mutually exclusive...

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21 Percent Pay Cut Kicked in April 1 — But MACs Are Holding Claims

No legislative wrangling can take place until April 12.

Unless Congress steps in soon, you could be facing the 21.2 percent Medicare pay cut that you’ve feared since January.

Despite several Congressional attempts to cobble together another temporary pay fix...

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Don’t Bill One Physician Incident-To Another

Find out what incident-to requirements you have to meet.

Question: Is there any circumstance in which a group can bill all services and all providers (including other physicians) under just the head doctor? I know we can bill NPP...

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Use Shared Visit to Capitalize on NPP/Physician Teamwork

Forget about incident-to in the facility, but consider this similar billing technique.

ED coders that have never heard of “incident-to” billing have nothing to worry about, as you cannot code for “incident-to” services in the hospital. Coders that don’t understand...

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Cardio Challenge: Discover Event Monitor Disconnect Date’s Proper Place

Find out where to report date of services on your claim form.

Question: Which date(s) of service should I report for 30-day cardiac event monitoring?

Washington Subscriber

Answer: For Noridian Medicare, your Part B administrator for Washington, you’ll need to...

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CMS Speaks: Weigh Your 2-Payer Consult Coding Options

In MSP cases, non-consult code for both payers may be best.

If you have payers who didn’t play follow-the-leader with Medicare in cutting out consult codes, you have a dilemma on your hands. You have to decide what to do...

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Use This Sample Appeal Letter As Ammo in Your Fight Against Modifier 25 Denials

Attach your procedure notes and the OIG’s report to pack extra punch.

Even if you follow all of CMS’s rules in reporting modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the

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CMS Publishes Q&As Regarding Services Previously Billed As Consults

Medicare’s elimination of payment for consultation services has caused mass confusion throughout the coding community, not just due to the changes it has caused in your billing procedures, but also due to lack of information from CMS.

In an apparent…

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Medicare Physician Pay Cut Update

On Tuesday evening, the Senate passed H.R. 4691, which freezes the Medicare conversion factor at current levels through March 31.

Because of this vote, you will not face the 21% pay cut until April 1, explains Part B Insider editor,…

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  2. SGR Update: What’s Up With That 21 Percent Physician Pay Cut? Here’s what you should be watching on Capitol Hill....
  3. How Obama’s Medicare Cuts Hit Physician Reimbursement  The budget released Thursday suggests we cut $300 billion from...

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CMS Tells MACs to Hold Claims For 10 Days

The latest on the 21 percent Medicare pay cut.

If your practice leans heavily on Medicare for reimbursement, expect your cash flow to taper off a bit.

CMS has instructed the MACs to hold claims for the first ten business…

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Think You Understand the New Consult Rules? Find Out Fast

Test your 2010 consultation coding understanding with these questions. Consultation coding has every practice on edge this year. Ensure that you’ve got a handle on this complicated coding and billing situation by trying your hand at this question. Question: When a visit with a Medicare inpatient that would normally have been coded as a consultation does not [...] Related articles:

  1. Think You Understand the New Consult Rules? Find Out FastCheck your 2010 consultation coding savvy. Find out if you’re...
  2. Ask 3 Questions to Head Off 2010 Consult Problems Before They Start Ever used an unlisted E/M code? Get ready. By...
  3. CMS Will Soon Issue Consult Code Replacement Advice, According to Open Door ForumPlus: You can now download a list of all practitioners...

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