In Billing
Mar 16th, 2020
On Jan. 30, the World Health Organization (WHO) declared the 2019 novel coronavirus (COVID-19) disease outbreak a public health emergency of international concern. The outbreak has since been elevated to a pandemic and President Trump has declared the coronavirus pandemic a national emergency in the United States. Communities across the country are shutting down to ...
Mar 6th, 2020
April 1 is around the corner and you know what that means: quarterly updates. The Centers for Medicare & Medicaid Services (CMS) has released payer and provider guidance. Make sure all coding and billing staff are aware of the Medicare fee schedule changes. Two New Physical Therapy Codes MLN Matters® article MM1161 Revised, issued Feb. ...
In Billing
Mar 3rd, 2020
Failure to adopt the X[ESPU] modifiers may be putting your practice at risk for Medicare fraud. Modifier 59 Distinct procedural service continues to be the most-used modifier among Medicare Part B providers, according to Novitas, and it is sending up red flags for possible Medicare fraud and abuse. Representatives from the Medicare Administrative Contractor (MAC) ...
In Audit
Feb 11th, 2020
MACs may be applying the multiple endoscopy rule incorrectly. In the 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized the proposal to apply the special rule for multiple endoscopic procedures to the family of functional endoscopic sinus surgery (FESS) codes. Real-world Scenario Practices are now getting ...
In Billing
Feb 3rd, 2020
Part 3: Look out for insurance roadblocks and instill policies to ensure coverage for needed healthcare. Over the last couple of months, we have discussed how you can help transgender patients overcome challenges by knowing the limitations of electronic medical records (EMRs) and the importance of good data collection and registration; how the Diagnostic and ...