Avoid misconceptions and clarify guidelines to make end-of-life services less intimidating. Hospice is a Medicare Part A benefit most often provided to terminally-ill patients who wish to remain in their homes. Medicare guidelines for hospice are detailed and can be arduous, however, making billing and reimbursement tricky. An overview of the guidelines and clarification of ...
In Billing
Oct 23rd, 2018
An important update has been made to the Medicare National Coverage Determinations (NCD) Manual regarding coverage of magnetic resonance imaging (MRI) for patients with certain implantable cardiac devices. In a National Coverage Analysis (NCA), the Centers for Medicare & Medicaid Services (CMS) determined there is sufficient evidence to conclude MRI for patients with certain implantable ...
In Billing
Oct 23rd, 2018
Are your clinicians reporting patient relationship codes on their Medicare Part B claims? The HCPCS Level II modifiers are voluntary this year, making it a good time to get in practice. What Is the Purpose of Patient Relationship Categories and Codes? The Medicare Access and CHIP Authorization Act of 2015 (MACRA) requires the Centers for ...
In Billing
Oct 19th, 2018
A beginner’s guide to claims code editing logic. The U.S. healthcare system is highly complicated and extremely expensive. There are many layers between the provider of medical services and the payment for those services. This overly complex system leads to inefficiencies resulting in incorrectly paid claims and the need to spend even more time and ...
Avoid payer denials by ensuring your provider or supplier follows the rules for allowable MUE units. Understanding why Medically Unlikely Edits (MUEs) were established, how they are organized, and the criteria on which edit rationales are based may help medical coders and billers avoid denials or, at a minimum, properly resolve a denial. What Are ...