Following 10-year-rule eliminates G0121 rejection.
If you slip up on screening colonoscopy claims’ frequency guidelines and eligibility requirements, Medicare will pay you zilch.
Use this guidance to capture every screening dollar your gastroenterologist deserves.
Home in on Eligibility Requirements for...
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...
Pre-authorization snag may require ABN.
If your practice performs MR urograms, you need to be prepared to handle a few reimbursement roadblocks.
You may find conflicting information in researching how to code MR urograms. For example, you may come across...
Grasping 93010’s effect on new vs. established patient status could bring a $58 reward.
Whether you call them ECGs or EKGs, chances are you see a lot of electrocardiograms in your practice. That means that even the tiniest coding errors...
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…
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,…
Related articles:Don’t sweat reporting 38220-59 if you meet these Medicare-approved conditions. If your oncologist takes both a bone marrow biopsy and a bone marrow aspiration, whether you’ll see Medicare reimbursement depends on the two guidelines below. But watch out: With OIG scrutiny and a HCPCS twist, these guidelines will put your coding savvy to the test. Append 59 [...] Related articles:
Beware: CPT, CMS differ on ‘family discussion’ parameters. When the physician treats a patient with a critical illness or injury, you need to know when to start and stop the critical care clock in order to avoid miscoding. Check out this FAQ to find out what’s part of critical care, what’s not, and how to correctly [...] Related articles:
Here are the requirements the exam must meet, according to Medicare. If your PET claim meets certain requirements, you don’t need to append modifier Q0 (Investigational clinical service provided in a clinical research study that is in an approved clinical research study), according to MLN Matters article MM6753. Effective for dates of service on or after Nov. [...] Related articles:
Bonus: Effective immediately! You’re probably accustomed to CMS taking away coverage for certain services, but in an early holiday gift to practices, CMS has actually added a preventive care service to its roster of covered screenings, effective immediately. CMS issued a final decision on Dec. 8 declaring that HIV testing will now be covered for Medicare beneficiaries [...] Related articles:
Hey, Coding News readers! It’s your turn to weigh in on the consult controversy. Question: What should you do for Medicare 2010 coding if an inpatient consult on a patient’s initial hospital day does not support 99221? Answer: Kenneth Simon, MD, MBA, FACS, CMS, senior medical officer at the CPT symposium was very adamant that you [...] Related articles:
CMS auditors will look for 1 less thing in consult documentation. With Medicare’s invalidation of consultation codes 99241-99255 in 2010, your ICD-9 codes better prove why two MDs are necessary on the same patient’s hospital care or the physician better specify why in his note. Separate ICD-9 codes will help substantiate the medical necessity for providing consultative [...] Related articles:
Prevent 99251-99245 denials in 2010 with this checklist. Multiple physicians using the same hospital codes sounds like a recipe for denials, but that’s what Medicare is instructing physician inpatient consultants and care coordinators to do. Whether carriers will kick out these submissions as coordination of care or inpatient admit limiting admit edits is contractor specific, Charles [...] Related articles:
New rules for consult coding straight from the AMA Meeting in Chicago — plus where your practice will gain and lose reimbursement. If you can’t figure out how to match a low level consult to an initial hospital care code, you’re not alone. Code 99251 doesn’t crosswalk to 99221, agreed William J. Mangold, Jr., MD, JD, Noridian [...] Related articles:
It’s that time of year coders — yes, time to comb through pages and pages and pages of the final 2010 Medicare Physician Fee Schedule. We’ve got a handy place to start. If you want a quick overview of fee schedule’s financial impact on your physician practice’s specialty, go here and scroll to page 1171. There, [...] Related articles:
Here’s why you should keep your physicians’ work schedules on file. Correctly billing your nonphysician practitioners (NPPs) incident-to services means the difference between 85 and 100 percent reimbursement. But if you bill incident-to haphazardly, you’re just waving a red flag at auditors. And those auditors are jonesin’ to find incident to billing problems. Just check out this [...] Related articles: