Provider News

HCPCS 2010: CMS Debuts New J Codes

Synvisc, penicillin get new codes — along with injectibles for neurology, bleeding. Hot on the heels of the new CPT codes, CMS follows suit by publishing the 2010 HCPCS code set, posted on the CMS Web site on Nov. 3. You’ll find scores of changes. What follows is a small sampling of what you’ll face in 2010: Synvisc: HCPCS will [...] Related articles:

  1. Which HCPCS Code Should I Use for Eovist MRI contrast? Question: Which HCPCS code should I use to report...
  2. 2 New HCPCS Codes for H1N1 Vaccine AdministrationPlus: New Bevacizumab code is effective Oct. 1. If you’re...
  3. 2010 CPT Category II & III Codes You Might Miss Yes, our CPT books are fountains of knowledge, but...

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November 10, 2009
CPT 2010 / Provider News

CPT 2010 Update: Non-Face-to-Face Prolonged Services

New Year’s hats & horns for looser guidelines that let you count work spread over days. Groaning thinking of all the time you’ll never capture for complex cases requiring extensive pre-visit time? CPT 2010 brings you hope. Extensive guideline revisions “liberalize prolonged non-face-to-face services codes,” reports Richard Tuck, MD, FAAP, pediatrician at PrimeCare of Southeastern Ohio in [...] Related articles:

  1. Asthma Attack Coding: When To Use Prolonged or High-Level E/M     Checklist deters payback requests for insufficient +99354...
  2. Bust 4 Myths About Pediatric Critical Care Services MYTHBUSTER: Codes 99291, +99292 apply to infants, young pediatric...
  3. Watch Out for 3 Telephone Service Coding PitfallsCaution: You may need to incorporate the call into an...

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November 5, 2009
Provider News

Big Insurers Underspend On Medical Care, Senate Probe Finds

Which big health insurance company did lawmakers single out? Is it the one that gives you the most denials trouble? A US Senate probe confirms what many coders and billers have been suspecting all along — that six major medical insurers aren’t spending as much as they should providing actual health care. Insurance industry officials say that [...] Related articles:

  1. Insurers Offer to Charge Sick People Less …… and healthy people more. In an unexpected move last...
  2. $12,910 More Per Year For Health Insurance?Imagine a world where insured patients pay DOUBLE the health...
  3. Stimulus Package Crash Course for Health Care ProvidersIf your head is swimming trying to figure out what...

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November 3, 2009
CPT / modifier 22 / Provider News

Surgical Coding Update: 21930, 21931 & More Debut for CPT 2010

Tumor excision codes get specific. Will surgical oncology practices take a reimbursement hit? We’re starting to learn what new CPT codes we’ll be using come January 1, 2010. Coding News will keep you posted over the coming weeks, along with analysis from coding experts around the country so that you know what to expect for your practice’s [...] Related articles:

  1. Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready...
  2. 141 New ICD-9 Codes Debut for 2010 Like a passel of fresh-faced debutantes, the new ICD-9...
  3. Surgical Coding: Modifiers 58, 78, and 79SURGICAL MODIFIER CHOICES Surgery Modifier Choices are Key to Surgery...

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October 27, 2009
Audit / Cardiology / Oig / Provider News

OIG Auditors to Cardiologist: You’re Billing Medicare Properly

Report reveals what he and his billing staff did right. Does your practice have the right stuff? Turns out the old saying is true: If you haven’t done anything wrong, an OIG audit is nothing to worry about. A New York cardiologist who collected over $1.3 million over a three-year period for 5,061 claims caught the OIG’s [...] Related articles:

  1. Double Ultrasound Codes Spell Double Trouble With AuditorsAuthorities scrutinize medical necessity for 76830 & 76856. The OIG...
  2. Medicare Fraud Fighter Reveals 9 Billing Patterns That Draw HEATA Department of Justice senior trial attorney behind the widely...
  3. HHS Plans to Crack Down on Fraud, Improper BillingMedicare loses $60 billion a year in improper payments. A...

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October 20, 2009
Audit / MAC / modifier GY / Provider News / RAC

A Physician Coder’s Guide to the 2010 OIG Work Plan

If your practice does lab panels, sleep studies, hospice visits and more, take heed. The HHS Office of Inspector General has published its 2010 Work Plan, which should give us all a heads up on what the watchdog agency will be auditing and evaluating this year. Why you should care: The 115-page document is like a map [...] Related articles:

  1. Proposed 2010 Physician Fee Schedule: A Closer Look21.5 percent cut looms for your services Last week, Coding...
  2. New PQRI, E-Prescribe Tool from CMS If your head is spinning with all of the...
  3. How Obama’s Medicare Cuts Hit Physician Reimbursement  The budget released Thursday suggests we cut $300 billion from...

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October 13, 2009
Provider News

More Health Care Services = Higher Costs

Private nursing homes now cost $10 more than it did last year.

You may have to allot more on long term care from your budget as the yearly survey by a financial firm has found its costs are continuously on...

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December 31, 1969