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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Ob-gyn Coding Challenge: Deliver Postpartum V Codes With Care

Bonus: Get exposure to ICD-10 coding equivalents.

Question: A mentally-challenged patient who delivered at home was admitted to the hospital for postpartum care. The patient delivered the placenta at home, and once admitted, she had no complications, but the ob-gyn

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Breathe New Life Into Your Asthma Coding Claims

Focus on form and drug to pinpoint the correct asthma supply code.

Are you clear on how to report asthma procedures and inhalers? Follow this advice, and you’ll breathe easy when it comes to asthma related claims.

Propellant-Driven Inhaler Falls

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Ensure Multi-Vaccine Payment With This Coding Advice

You may need to append modifier 25, depending on payer policies.

Question: Our physician billed 90634, 90710, and 90606 for vaccines given to a 5-year-old patient. The insurance company denied payment and said they required a modifier. What should we

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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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EM Coding: Should I Select 99211 for Most Med Checks?

Insurers might want to see a clear explanation as to why the E/M was necessary.

Question: An established patient with a plan of care in place for her gastroesophageal reflux disease (GERD) reports to the gastroenterologist; two weeks ago, the

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E/M Coding: Use Current Diagnosis to Support E/M Visit

Don’t forget to include the code for the arthrocentesis.

Question: A new patient sees the orthopedist because of shoulder problems. The physician schedules an MRI and the patient returns the following week to discuss the findings. The physician had already

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Think You Understand the New Consult Rules? Find Out Fast

Check your 2010 consultation coding savvy.

Find out if you’re set to properly code your physician’s consultation services this year by tackling three problems and their solutions.

Check With Your MAC for Guidance

When…

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  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 Offer New Modifier to Denote Admitting Physician on ClaimsPop the champagne cork & get ready for brand new...

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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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