In CMS
Jan 23rd, 2020
Medicare patients are receiving calls from telephone solicitors who are phishing for private identification information for nefarious purposes. The ruse is facilitated by the issuance of new Medicare cards. Here’s How the Scam Goes Down The callers claim to be from Medicare and say there has been a mix up in the assignment of new ...
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 Audit
Jan 3rd, 2020
Coding initial hospital care became more challenging after Medicare stopped paying for inpatient consult codes several years ago — but that can’t be the only factor driving the startling error rates for evaluation and management (E/M) codes 99223 and 99214. In the report “2019 Medicare Fee-for-Service Supplemental Improper Payment Data,” the Centers for Medicare & ...
In CMS
Dec 30th, 2019
Many clinicians earned Qualifying Alternate Payment Model Participant (QP) status during the 2017 performance period of the Quality Payment Program (QPP). But a long list of them are still eagerly awaiting their 5 percent lump sum incentive payment. The Centers for Medicare & Medicaid Services (CMS) began disbursing the 5 percent APM incentive payment to ...
In CMS
Dec 27th, 2019
If the Medicare Payment Advisory Commission (MedPAC) gets its way, lawmakers will require Medicare to reduce the hospice aggregate cap amount by 20 percent and freeze hospice payment rates for 2021. A 20 percent cap reduction would equal nearly 3 percent less in hospice payments. MedPAC Recommendations In its forthcoming March report to Congress, MedPAC will include ...