Providers are bracing for the end of government funds to administer COVID-19 vaccines. Starting Tuesday, April 5, the Department of Health and Human Services will no longer adjudicate claims submitted…
CMS has raised the Medicare payment rate for certain COVID-19 antibody infusions and included a new payment policy for at-home administration, which will have a higher payment rate compared to…
Get maximum reimbursement for treating asthma with the right codes. Getting paid requires accurate documentation and selecting the correct codes. In our Coding Case Studies, we will explore the correct…
HRSA is not a HIPAA-covered entity, so the official coding rules do not need to be followed when submitting claims. EDITOR’S NOTE: On this week’s Monitor Mondays, Dr. Ronald Hirsch…
Medicaid improper payments, including fraud, have spiked in recent years, reaching $37 billion in 2017, according to a government watchdog agency. And the Centers for Medicare & Medicaid Services (CMS)…
Radiology, as a business, has become increasingly complex as regulatory demands grow and revenues, both on the hospital and physician side decrease. Doing more with less has become a common…
Z23. That’s the ICD-10 billing code for an immunization encounter. It’s also the only code that stumped the team at Arlington, Virginia-based Privia Health, a national medical group. “It’s a…
Reimbursement for procedures is an ASC's bread and butter. Here are eight things to know about surgery center reimbursement. 1. Surgery center reimbursement comes from several sources, according to the…
University of Illinois at Chicago researchers have developed a website that walks healthcare providers through the challenging transition from the current International Classification of Diseases -- ICD-9 -- to the…
Physicians are very often so stressed out with seeing an increasing number of patients, providing medical services and appropriate follow-ups that they hardly get any time to see to the…
In an effort to scale back use of high-priced imaging of questionable value in cancer treatment, Medicare has proposed ending reimbursement for post-treatment positron emission tomography scanning in prostate cancer…
Manipulation under anesthesia is a treatment that includes manipulation of multiple body joints for chronic pain conditions and is performed in ASCs by orthopedic surgeons and specially trained chiropractors. According…
The Centers for Medicare & Medicaid Services (CMS) Transmittal 1058, Change Request (CR) 7767 confirms a zero percent update for payments under the Medicare Physician Fee Schedule (MPFS) through year’s end.
Here’s what you should be watching on Capitol Hill. It’s that time of year again — the time when we all bite our nails wondering if Medicare will slash physician payments in the New Year. This year, the drama is more intense as Congress decides whether to permanently repeal the Sustainable Growth Rate (SGR) formula that creates [...] Related articles: