CMS / CPT / Medicare / Provider News

Medicare Changes to 2010 CPT Inpatient Consultation Codes

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:

  1. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...
  2. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...
  3. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open...

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November 13, 2009
CPT / Hot Coding Topics / Medicare

Medicare 2010 CPT Consultation Code Changes

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:

  1. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  2. CMS at AMA Chicago: We’re Reducing Consult Request RequirementCMS auditors will look for 1 less thing in consult...
  3. Consultation 5 R’s Miss 1 element, and invite auditors to check out...

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November 12, 2009
Medicare / Toolkit

Coder’s Navigation Tool: 2010 Medicare Physician Fee Schedule

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:

  1. Proposed 2010 Physician Fee Schedule: A Closer Look21.5 percent cut looms for your services Last week, Coding...
  2. How Obama’s Medicare Cuts Hit Physician Reimbursement  The budget released Thursday suggests we cut $300 billion from...
  3. CMS Issues Corrections to 2009 Physician Fee Schedule Final RuleIt’s that time of year again — time to get...

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November 8, 2009
Coder's Cranium / Medicare / Oig

Nonphysician Providers and Incident-To: Your Coding Questions Answered

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:

  1. Nonphysician Providers & Incident To ChecklistCheck state laws PLUS this crucial document. In last week’s...
  2. Steer Your Incident-To Coding Using These 4 Questions 100 percent pay possible if NPP follows internist’s care...
  3. Use This Incident-To Checklist to Breathe Easy During an Audit You don’t need to second-guess the way you bill...

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October 25, 2009
CMS / Hot Coding Topics / MAC

Medical Office Billing: 7 Ways to Escape Computer Claim Casualties

Pay attention to EOBs and keep talking to your MAC. You could be losing money to a computer glitch and not know it, experts say. If you don’t nip a computer glitch in the bud, you may be plagued with improper denials and other claim holdups. Here are seven things you can do to seek out and [...] Related articles:

  1. Coders: Watch Out for Claim-Denying Computer Glitches Don’t wait for your MAC to alert you to...
  2. Medical Office Billing: Benefits Verification, Copayment and Consolidated BillingIs Lack of Verification Costing Your Practice? Stop the Bleeding...
  3. Make Even Problem Payers Pay Up With These Tips From 2 ProsFollow this 3-step path and get results from every payer. At...

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October 21, 2009