Here’s what you need to explain in your cover letter....
Keep signature, modifier 59, and ‘Incident To’ guidelines front and center.
If you’ve been worrying that the oncologist’s illegible signature on an order is going to come back to haunt your practice in an audit, CMS has offered
answers...
Plus: CMS reps cite current Medicare law and advise that practices should report just one inpatient care code per patient, per day.
Although CMS has eliminated payment for consult codes, it will continue to honor split/shared visits — as long...
But because legislators missed the cutoff by one day, some claims were processed using a lower rate.Although the government appeared poised to take a big bite out of your next Part B payments, you have another month before...
Question: Our hospital billing and medical departments say that diagnoses we add to a claim for reimbursement must have a physician endorsement. We’ve researched our Local Coverage Determination (L26884) from National Government Services, the Ingenix Coding & Payment Guide for...
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...
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...
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...
Upcoming policy change will slash your payments by half.
Big changes are on the horizon if you participate with insurance provider Horizon Blue Cross Blue Shield (BCBS) of New Jersey.
In a recent memo, BCBS states that effective May 17,...
Don’t let ‘wrong surgery’ modifier mistakes stall your reimbursement.
You use modifier TC for the technical component of a test. So logically, you should use modifier PC for the professional component, right? Wrong. But many coders are making that mistake...
Find out what steps Congress must take to delay the much feared 21.2 percent pay cut.If a new bill — already approved by the Senate — moves forward, you could have another six months before the 21.2 percent...
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:Caution: Keep enough paperwork on hand to back up EHR. Transitioning to the world of Electronic Health Records (EHR) can make your coding easier on many levels, but don’t take it for granted. Physicians often fall short in their review of systems (ROS) documentation whether you use paper charts or rely on EHR, but you can [...] Related articles: