Watch for five claims shortcomings that may hang up claims payment. If the results of an April 2018 Office of Inspector (OIG) audit are any indication, claims for telehealth services are about to receive much closer attention by payers. Physicians and staff can best prepare for a potential claims review through awareness and education. Rising ...
In Coding
Aug 8th, 2018
Typical post-operative care, including related evaluation and management is not separately reportable; but, an unrelated evaluation and management service during a postoperative period may be. According to the Centers for Medicare and Medicaid Services (CMS), an E/M service provided during the global period of a procedure is unrelated if: • The E/M service is for ...
In CMS
Aug 8th, 2018
During a July 18, 2018 CMS Twitter™ podcast, CMS National Coordinator for Health Information Technology, Donald Rucker, M.D. defended the new CMS 2019 proposal to make documentation of the History optional for health records. He was asked, “In light of technology’s thirst for data to identify best practices and construct predictive algorithms, is it possible ...
In CMS
Aug 6th, 2018
Besides taking a machete to E/M reimbursement and the way Medicare looks at E/M services, the current administration has proposed some large changes in the way Medicare pays doctors. They have also proposed ways that hospital facilities disclose prices to patients, providing more transparency. Changing Payment The pipeline for immediate changes includes the government paying more ...
In Coding
Aug 3rd, 2018
In most cases, the appropriate date of service when services last more than one day is the day the service concluded. Radiology services typically have two components: professional and technical. The DOS for the technical component is the date the patient received the service. Professional claims for “reading” are billed the day the physician provided ...