In Billing
May 23rd, 2019
By Rebecca Caux-Harry, BFA, CPC One of the many benefits of working for a nation-wide company, such as 3M Health Information Systems, is visibility into payer actions from coast to coast. Many customers send us comments about payer actions and ask if we can help with some of the issues. This is an extremely valuable ...
In Billing
Apr 26th, 2019
The Patient Driven Pay Model (PDPM) will change the Skilled Nursing Facility (SNF) Prospective Payment System’s (PPS) method of classifying SNF patients in a Medicare-covered Part A stay Oct. 1.  The Centers for Medicare & Medicaid Services (CMS) provide a number of resources on their web site. Patient Driven Pay Model According to the Centers ...
In CMS
Apr 23rd, 2019
Beginning January 2020, primary care practitioners may qualify to participate in one of five new payment model options that focus on supporting care for patients who have chronic conditions and serious illnesses. The Centers for Medicare & Medicaid Services’ (CMS) Primary Care Initiative is a new set of payment models that will provide primary care ...
In Coding
Apr 21st, 2019
To select an appropriate code for excision of a benign (11400-11471) or malignant (11600-11646) skin lesion, you must determine the lesion’s diameter at its widest point, and add double the width of the narrowest margin (the portion of healthy tissue around the lesion also excised). In the interest of both clinical and coding accuracy, providers should ...
In Coding
Apr 21st, 2019
Question: In researching CPT® code 49905 Omental flap, intra-abdominal (List separately in addition to code for primary procedure), I found an article in AAPC’s Knowledge Center, dated 10/01/2013, titled “Omental Pedical Flaps,” that states this is an open surgical code. Does this mean I cannot this add-on code for laparoscopic procedures? Answer: Code 49905 describes the use ...