In Audit
Jan 8th, 2019
Explanation of Medicare Benefits (EOB) error message 96 Non-covered charge was the No. 1 reason for claims denials in December in all of Medicare Jurisdiction H, according to the region’s Medicare Administrative Contractor (MAC). “Prior to performing or billing a service, ensure that the service is covered under Medicare,” Novitas Solutions says on their website. ...
In Coding
Jan 2nd, 2019
When coding opioid use disorder, you’ll need to know the sequencing rules to select an appropriate ICD-10-CM code. Opioid abuse, addiction, and overdoses are a serious public health problem. According to the National Institute on Drug Abuse, more than 115 people in the United States die after overdosing on opioids, every day. The Centers for ...
In CMS
Dec 28th, 2018
Will the latest regulations governing accountable care organizations (ACO) deliver favorable results for all? The Pathways to Success final rule, released by the Centers for Medicare & Medicaid Services (CMS) on Dec. 21, 2018, offers several new participation options and flexibility to healthcare organizations in the Medicare Shared Savings Program (MSSP). Participation options are meant ...
In Coding
Dec 26th, 2018
When assigning a ICD-10-CM diagnosis code(s) for a surgical complication, report the code for the complication first, followed by any additional diagnosis code(s) required to report the patient’s condition. Example 1: Complication from a surgical procedure for treatment of a neoplasm. The complication is the listed first, followed by a code for the neoplasm or ...
In CMS
Dec 18th, 2018
Even though U.S. Northern District of Texas Court Judge Reed O’Connor struck down the Affordable Care Act (ACA or Obamacare), there are three good reasons to neither panic nor change your medical practice’s policies or your medical coding. Judge O’Connor ruled the law as unconstitutional, agreeing with 20 state attorneys general that the Individual Mandate ...