In Billing
Jan 21st, 2020
New patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty in the same multi-specialty group sees the patient for the first time and bills a new patient E/M ...
In Billing
Jan 13th, 2020
In my last blog “Special Rules Apply to Endoscopic Sinus Surgeries,” I discussed the change to the Multiple Endoscopy Rule for multiple surgeries when performed within the family of endoscopic sinus codes. How Does the Multiple Endoscopy Rule Affect Payment? Using the multiple endoscopy rule with the base code 31231 Nasal endoscopy, diagnostic, unilateral or ...
In Billing
Dec 27th, 2019
Patients are taking a more active role in their blood pressure (BP) monitoring, making it easier for physicians to diagnose and manage hypertension. “With the advance of new technologies for e-visits and health monitoring, many patients are realizing the best access point for physician care is once again their home,” said American Medical Association (AMA) ...
In Audit
Dec 17th, 2019
The Office of Inspector General (OIG) expects a banner year in recoveries stemming from fraud investigations and audits. According to the OIG semiannual report, released Dec. 2, the U.S. Department of Health and Human services (HHS) stands to recoup as much as $5.9 billion in federal funds in 2019, The semiannual report estimates the OIG will ...
In Billing
Dec 10th, 2019
Starting Jan. 1, 2020, Medicare claims submitted with the patient’s Social Security Number will be rejected. A simple way to prevent claims being rejected is to make sure all your Medicare patients have their new card. The Centers for Medicare & Medicaid Services (CMS) has been issuing beneficiaries new member cards with Medicare Beneficiary Identifiers ...