Here are the facts: Medicare is one of the largest insurance programs in the United States, and every year it helps insure more than 49 million seniors and other beneficiaries. And,…
The OIG has called on CMS to strengthen activities to prevent improper Medicare payments, including enhancements to the Recovery Audit Contractor (RAC) program. For instance, the OIG notes that RACs…
Contractors hired by Medicare to audit the payment records of healthcare providers have a good track record spotting improper billing, the Department of Health and Human Services Inspector General concluded…
The number of Recovery Audit Contraction (RAC) requests for medical claims reviews has increased “dramatically” since 2012, according to the American Hospital Association’s (AHA) newest RACTrac survey. More than 1200…
The health care industry is “not progressing at a suitable pace” to be ready for tens of thousands of new government-mandated “ICD-10” codes used to describe diseases and hospital procedures…
In an effort to reduce administrative burdens on hospitals and other providers, CMS has reduced the minimum medical record requests from Medicare Recovery Auditors — formerly known as Recovery Audit…
In an effort to scale back use of high-priced imaging of questionable value in cancer treatment, Medicare has proposed ending reimbursement for post-treatment positron emission tomography scanning in prostate cancer…
The Centers for Medicare & Medicaid Services (CMS) Transmittal 1058, Change Request (CR) 7767 confirms a zero percent update for payments under the Medicare Physician Fee Schedule (MPFS) through year’s end.
Question: My doctors stand by for the cardiologists during a pacemaker placement in case they need to place epicardial leads. They want to report their time, and I have found 99360 for this. Do they need to dictate something in order for me to charge f...
One element that physicians cheered in the new Medicare annual wellness exam has been eliminated and another that beneficiaries demanded will be delayed. Bowing to Republican pressure, the White House agreed to cut the voluntary after care planning tha...
On Jan. 3, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) opened the registration for the Medicare and Medicaid electronic health record (EHR) incentive programs. It was started in Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee, and Texas and broad participation is invited from eligible professionals and eligible hospitals who wish to participate.
In February, the registration will open in California, Missouri, and North Dakota and in other states during the spring and summer of 2011.
“With the start of registration, these landmark programs get underway, and patients, providers, and the nation can begin to enjoy the benefits of widespread adoption of electronic health records,” CMS Administrator Donald Berwick, MD was quoted as saying in the news release. “CMS has many resources available to help providers register and participate, and we look forward to working with eligible professionals and eligible hospitals to facilitate the process, beginning on January 3rd and going forward.”
“It’s time to get connected,” said David Blumenthal, MD, MPP, National Coordinator for Health Information Technology. “ONC and CMS have worked together over many months to prepare for the startup on January 3rd. ONC’s Certified HIT Product List includes more than 130 certified EHR systems or modules and is updated frequently. ONC also has hands-on assistance available across the country through 62 Regional Extension Centers. We look forward to continuing to work with CMS to assist eligible providers in 2011 and future years.”
The news release said that interested providers can acquaint themselves with the programs’ requirements by visiting CMS’ Official Web Site for the Medicare and Medicaid EHR Incentive Programs.
Eligible providers seeking to participate in the Medicaid programs must initiate registration at CMS’...
Despite adjusted rate of 33.9764, overall change is zero. The President locked in a zero percent adjustment to your Medicare Part B payments but that doesn’t mean you’ve got the same rate. The Medicare and Medicaid Extenders Act of 2010, wh...
If you’ve been writing off tobacco cessation counseling as non-payable, it’s time to change your tune.
The change: In the past, you could collect for tobacco cessation counseling for a patient with a tobacco-related disease or with signs or symptoms of one. But on Aug. 25, CMS announced that “under new coverage, any smoker covered by Medicare will be able to receive tobacco cessation counseling from a qualified physician or other Medicare recognized practitioner who can work with them to help them stop using tobacco.”
“For too long, many tobacco users with Medicare coverage were denied access to evidencebased tobacco cessation counseling,” said Kathleen Sebelius, HHS secretary, in an Aug. 25 statement. “Most Medicare beneficiaries want to quit their tobacco use. Now, older adults and other Medicare beneficiaries can get the help they need to successfully overcome tobacco dependence.”
Count Attempts and Minutes
The new tobacco cessation counseling coverage expansion will apply to services under Medicare Part B and Part A. That means your physicians and coders should know how to correctly document and report the sessions.
“Medicare allows billing for two counseling attempts in a year, but each attempt can occur over multiple sessions, with four sessions per attempt,” explains Jennifer Swindle, CPC, CPC-E/M, CPC-FP, RHIT, CCP-P, director of coding and compliance for PivotHealth LLC in Brentwood, Tenn.
According to section 12 of chapter 32 of the Medicare Claims Processing Manual, “Claims for smoking and tobacco use cessation counseling services shall be submitted with an appropriate diagnosis code. Diagnosis codes should reflect: the condition the patient has that is adversely affected by tobacco use or the condition the patient is being treated for with a therapeutic agent whose metabolism or dosing is affected by tobacco use.”
Swindle says 305.1 (Tobacco use disorder) is one diagnosis supporting...
You won’t face the same nail-biting payment woes in 2011 as you did this year, thanks to a Senate Finance Committee bill that will freeze Medicare pay at current levels for another 12 months. The House of Representatives passed the Medicare and M...
Get ready to change your flu vaccine product code 90658 to one of four Q codes. For 2010, report 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) to signify that your physici...
Medicare beneficiaries will be thrilled that Medicare will cover annual well checks. The Center for Medicare introduces a new benefit of wellness visits for beneficiaries annually, except during the year of their Welcome to Medicare exam. You’ll use ...