In Billing
Feb 14th, 2018
There are new and changed modifiers to use if you are adjusting oxygen volume. The Centers for Medicare & Medicaid Services (CMS) updated an October Transmittal better defining how to report oxygen amounts below 1 liter per minute, which reduces the fee schedule monthly amount for stationary oxygen by 50 percent. CMS’ rules for  volume adjustment say if ...
Feb 14th, 2018
Sexual harassment isn’t just a Hollywood problem coming into the limelight. It’s in nearly every workplace, including hospitals and physician practices. To help ensure your healthcare organization avoids incidents of sexual harassment, it’s important to have strict policies in place and to make sure your employees understand what constitutes inappropriate conduct. What Is Sexual Harassment? ...
In Billing
Feb 14th, 2018
The HCPCS Level II code G0475 HIV antigen/antibody, combination assay, screening is effective for dates of service on or after April 13, 2015, and is subject to Clinical Laboratory Improvement Amendments (CLIA) edits, despite its omission in previous transmittals from the Centers for Medicare & Medicaid Services (CMS). For Medicare reimbursement, G0475 requires a facility to have either a ...
Feb 13th, 2018
Here’s a stark reminder of the responsibilities  – and risks – of being a business associate: Aetna is suing the company that mailed 12,000 envelopes last summer revealing the recipients had HIV for $20 million and more. Aetna hired claims administrator Kurtzman Carson Consultants (KCC) to send letters notifying Aetna members of a settlement the ...
Feb 13th, 2018
Aetna is under investigation in California for allegedly not following protocol when making coverage decisions. One Aetna member, Gillen Washington, 23, claims it nearly cost him his life. Washington is suing Aetna for breach of contract and bad faith, according to CNN. Case for the Plaintiff Washington, who has common variable immunodeficiency (CVID), claims Aetna ...