In Audit
Oct 2nd, 2018
If you are a particularly observant medical coder, you’ve probably noticed that many codes identified as deleted were actually promoted to new roles. Nearly 50 codes were revamped to become parent codes of more specific codes,and it’s causing some confusion because some electronic coding systems mark them as deleted AND new. Same Codes Marked as Deleted/New Take ...
In Billing
Sep 28th, 2018
Patients may be asking providers’ staffs, including medical coders, about Aetna’s plan to sell its Medicare Part D drug plan business to WellCare Group. And providers’ staff should also stay on top of the change. Part D Sale to Help CVS Merger Aetna’s sale will affect 2.2 million members as of June, according to CNBC, but ...
In CMS
Sep 4th, 2018
 MLN Matters issued an article on July 11, 2018  to clarify that the Medicare Beneficiary Identifier (MBI) format does not use the letters S, L, O, I, B, and Z. This was done so that there will never be a confusion between the numbers 5, 1, 0, 3, and 2.  Keep in mind that whenever you see a ...
The Centers for Medicare and Medicaid Services (CMS) released a Final Rule freeing more than $10.4 billion to anxious payers to continue the Affordable Care Act’s (ACA) risk adjustment program. The agency had halted payments to payers while a New Mexico ruling was challenged, but in the end the activity unnerved the industry and didn’t change much. Risk Adjustment ...
In Audit
Jul 17th, 2018
  Proposed changes in the Medicare Physician Fee Schedule (MPFS) for 2019 will change proposed reimbursement single evaluation and management (E/M) rates. Here’s a way for medical coders to see how much the new routes may affect your workplace’s reimbursement. This exercise will also help you determine what to share with CMS during the comment ...