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...
Medicare won’t pay 69210 alone, so here’s how to unlock payment.
Impacted cerumen removal is a fairly straightforward procedure, but billing for the procedure is not always so simple.
The problem: Most payers, including Medicare,consider 69210 (Removal impacted cerumen [separate...
Decipher what column 1/column 2 means in this neurosurgery bundle example.
Question: Would you explain what the differences are between mutually exclusive and “column 1/column 2″ edits that come from the Correct Coding Initiative (CCI)?
Florida Subscriber
Answer: Mutually exclusive...
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...
Examine Medicare’s coverage guidelines.
Question: My ob-gyn sees a patient who has breast implants or breast augmentation and orders a mammogram. Should I count the mammography as a screening or a diagnostic test?
Louisiana Subscriber
Answer: Implants and augmentation...
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...
In MSP cases, non-consult code for both payers may be best.
If you have payers who didn’t play follow-the-leader with Medicare in cutting out consult codes, you have a dilemma on your hands. You have to decide what to do...
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…
Medicare’s elimination of payment for consultation services has caused mass confusion throughout the coding community, not just due to the changes it has caused in your billing procedures, but also due to lack of information from CMS.
In an apparent…
The latest on the 21 percent Medicare pay cut.
If your practice leans heavily on Medicare for reimbursement, expect your cash flow to taper off a bit.
CMS has instructed the MACs to hold claims for the first ten business…
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:
CMS won’t fix CCI blunder until version 16.1, to be released in the spring. If your heart skipped a beat when you saw that January’s Correct Coding Initiative (CCI) edits bundled catheter ablations with electrophysiology (EP) studies, you weren’t alone. Good news: CMS has decided to delete the edits retroactively because their addition was a mistake, according [...] Related articles:
Fear not: The CF may stay until autumn, but the current snow storm is delaying the official word. Practices that were looking for a permanent change to the sustainable growth rate (SGR) formula before March 1 may come up empty-handed. However, Congress appears to be planning to offer an extension of the pay cuts that you’re [...] Related articles:
Plus: You can now download a list of all practitioners who can order/refer. If you’ve been confused about how to report low-level hospital visits now that consult codes are gone, you aren’t alone. CMS intends to tackle this problem by issuing more specific guidance on the topic in the near future. That’s according to a Feb. 2 [...] Related articles:
Beware: Don’t use the CMS consult crosswalk for billing purposes. You may be seeing light at the end of the tunnel. The AMA just published an article to clarify the use of the consultation codes for non-Medicare patients, and talks about their efforts to get CMS to delay their new policy. You can find the article [...] Related articles: