In CMS
May 24th, 2018
Beginning Oct. 1, modifier KH needn’t be appended to purchased capped rental durable medical equipment (DME) or parental/enteral items or services. Simplifying KH According to Transmittal 4052CP from the Centers for Medicare & Medicaid Services (CMS), Medicare Aministrative Contractors (MACs) won’t require KH DMEPOS item, initial claim, purchase or first month rental, as before. Ca...
Follow the correct edit to promote payment and avoid denial. By Samantha Prince, BSHCM, COC, CPC, CPMA National Correct Coding Initiative (NCCI) edits for Medicare and Medicaid are not the same. If you’re following Medicare edits for Medicaid claims, you may have claims denying inappropriately. That’s missed revenue you could capture by applying the correct ...
Manager of Professional Billing & Coding, Rady Children’s Hospital, San Diego, Calif. Tell us a little bit about how you got into coding, what you’ve done during your coding career, and where you work now.  I became interested in the healthcare field after I graduated from high school. It seemed like a challenging career that ...
New programs enable clinicians to avoid 2019 MIPS penalties with minimal data reporting. The Quality Payment Program (QPP) combines the Physician Quality Reporting System (PQRS), Meaningful Use (MU), and Value-based Payment Modifier (VBM) programs under a single reporting umbrella known as the Merit-based Incentive Payment System (MIPS). Eligible clinicians who do not participate in MIPS ...
Changes meant to clarify reporting and billing open a can of worms, instead. By Terri Brame Joy, MBA, CPC, COC, CGSC, CPC-I The Centers for Medicare & Medicaid Services (CMS) made several changes and clarifications regarding Part B billing for telehealth services in the 2017 Medicare Physician Fee Schedule (MPFS) final rule. What was meant ...