May 23rd, 2018
In what reads like a cheesy TV script, a McAllen-area, Texas physician is being charged of healthcare fraud and abuse by abusing patients and money laundering by the Department of Justice (DOJ) to the tune of $240 million. Jorge Zamora-Quesada faces a seven-count Grand Jury indictment alleging he and his co-conspirators “orchestrated a massive fraud scheme that jeopardized ...
In Billing
May 23rd, 2018
Here’s a summary of the changes for the July update to the 2018 Medicare Physician Fee Schedule Database (MPFSDB). Changes are effective for dates of service on and after July 1, 2018. Indicator Change for RHC and FQHC Care Management Codes For the following two HCPCS Level II codes, the PC/TC indicator is changed to 0 (zero) ...
In Billing
May 23rd, 2018
Starting Oct. 1, hospital discharges to hospice care qualify as a post-acute care transfer and may have payment adjustments for Medicare patients. According to the Centers for Medicare & Medicaid Services (CMS) Transmittal 2055, change request 10602, under the policy regulations § 412.4: * When a patient is transferred to another hospital and their stay ...
In CMS
May 22nd, 2018
A lot of people have been asking questions about how to code FESS surgeries with the new combination codes when three or four sinuses are operated on. Sinus and FESS We have been expecting an AMA CPT® Assistant article with guidance this year, but no instructions have come from the AMA.  I went to the ...
In Billing
May 22nd, 2018
If you don’t think there is a need for more research on medicinal marijuana, just turn to Parkinson’s disease (PD) patients: cannabis gives them hope of subsiding tremors and alleviating dyskinesia. For example, there is Rochester, New York’s Frank DeBlase, a 51-year-old who has been battling Parkinson’s for 17 years, has undergone brain surgery for ...