In Billing
Feb 22nd, 2019
Is your outpatient facility on board with new regulations for the ordering and furnishing of advanced diagnostic imaging services? Advanced diagnostic imaging services have long been under scrutiny by the Office of Inspector General for Medicare fraud and abuse, and the Centers for Medicare & Medicaid Services (CMS) responds to the watchdog’s recommendations each year ...
In Audit
Feb 20th, 2019
I was recently asked by a medical coder if I thought our professional services would soon become obsolete as more and more computer-assisted coding (CAC) applications are developed. I did not have to think about this for very long because CAC increasingly has been brought on line in many specialties over the past 10-15 years. ...
In Billing
Feb 15th, 2019
Code changes for the April update to the 2019 Medicare Physician Fee Schedule Database (MPFSDB) are effective for dates of service on and after Jan. 1, 2019. Medicare Administrative Contractors (MAC) will not search their files to retract payment for claims already paid or to retroactively pay claims. To ensure proper claims payment, providers will ...
In Billing
Feb 14th, 2019
The Centers for Medicare & Medicaid Services (CMS) released, Feb. 1, maintenance updates for several National Coverage Determinations (NCDs) to reflect recent code changes (CR11134). Every year, when ICD-10, CPT®, and HCPCS Level II codes are updated, NCDs (and Local Coverage Determinations) must also be updated. When this occurs, it’s essential for providers to review ...
In Audit
Feb 13th, 2019
Right out of the gate, Medicare Incentive-based Payment System (MIPS) adjustments were incorrectly applied to nonphysician services and supplies. This error is being corrected by the Centers for Medicare & Medicaid Services (CMS), but what if no one caught it? MIPS eligible clinicians and clinician groups could have improperly lost or gained considerable revenue. This ...