How Much Weight do MAC Policies Really Carry?

Providers should keep in mind that such policies aren’t binding – but can offer valuable direction. Imagine your Medicare Administrative Contractor (MAC) had a policy detailing their coverage of records…

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4 tips on negotiating contracts with commercial payers

Securing successful contracts with payers is becoming increasingly important for ASCs as they move toward negotiating value-based contracts. Lisa Davis, administrator at The Center for Minimally Invasive Spine in Munster,…

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The Devil’s in the Details of Two New Proposed Rules

More than 700 pages of text make up proposed changes to the federal Stark and anti-kickback statutes. On Wednesday, Oct. 9, federal healthcare officials announced two new proposed rules.  While…

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3 Coding Compliance Strategies to Improve Reimbursement, Quality

Medical coders are typically behind the scenes of patient care, analyzing records, selecting codes for billing, and managing patient data. But to Jannifer Owens, a revenue cycle expert with over…

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Looming medical billing and coding changes in healthcare policy

A change in government payment policy for dermatologists and other physicians in selecting office coding and billing for evaluation and management (E/M) is scheduled to begin January 2021. “The Centers…

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Hospitals support medical billing changes, opioid payments

Hospitals support the CMS' proposed changes to medical billing coding and new payments for opioid treatment programs, but they're worried that changes to quality measures could hurt providers. Major medical…

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Medicare Retires G Codes for Mammograms

October is Breast Cancer Awareness Month. Make sure your practice’s medical coding for preventive screening mammograms is up to date with current guidelines. Coding Mammograms for Medicare The Centers for…

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The Vaping Epidemic Worsens

Confusion persists for the coding of vaping. The issue of vaping continues to generate national and international headlines. On Sept. 18, a teen from London, Ontario in Canada suffered a…

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Noridian’s Use of Scenarios Questioned

Noridian uses scenarios for the parenteral administration of iron in non-dialysis patients. The Noridian iron infusion Local Coverage Determination (LCD) is important for just about everyone since Noridian is the…

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Coding for hospital observation

Q: Is reporting of Current Procedural Terminology (CPT) codes 99218-99220 restricted to a single physician? A:  According to CPT guidelines, only the physician or non-physician practitioner (NPP) placing the patient…

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