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 ...
In CMS
Jul 12th, 2018
What eye services will Medicare cover and how was recently clarified by the Center for Medicare and Medicaid Services (CMS). What Does Medicare Actually Cover? Medicare Part B doesn’t normally cover normal services like exams and glasses, but it will cover services treated illness or injury. There are three requirements for coverage: They must fall within ...
Jun 27th, 2018
When it comes to a coder’s arsenal of resources to verify a physician’s medical coding accuracy, the staples of the trade are CPT®, ICD-9, ICD-10, and HCPCS Level II code books. But today, there are more options: electronic options. For example, encoder software such as AAPC Coder, which searches the four medical code sets using ...
In CMS
Jun 12th, 2018
Fifty professional societies and healthcare providers wrote a letter to Seema Verma, the secretary of the Centers for Medicare & Medicaid Services (CMS) asking that the agency reimburse three new CPT codes for remote monitoring. Remote Monitoring More than 99091 While expressing their gratitude that the 2018 Medicare Physician Fee Schedule includes 99091 Physician/healthcare professional collec...