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 ...
Become an expert in identifying, correcting, and preventing denials. Denied claims are as common and predictable as having a child spike a fever before a big holiday, and every practice or group finds itself wrestling with corrections and resubmissions. But if you ask AAPC’s Director of Curriculum Katherine Abel, CPC, CPB, CPMA, CPPM, CPC-I, AAPC ...
In Billing
Sep 20th, 2018
It’s time to update your seasonal influenza vaccine roster for the 2018-2019 season. Medicare provides coverage of the flu vaccine once per season (or more, if medically necessary) without any out-of-pocket cost to the Medicare patient. No deductible or co-payment/coinsurance applies. Healthcare providers are reimbursed for the vaccine and its administration. The administration code for ...
In Billing
Sep 17th, 2018
CMS has issued waivers to ensure Medicare beneficiaries affected by the storm receive healthcare services. President Trump declared a state of emergency on Sept. 11 for North Carolina, South Carolina, and the Commonwealth of Virginia. That same day, U.S. Department of Health and Human Services Secretary Alex M. Azar II declared a public health emergency for ...
Sep 11th, 2018
Scrubbing is the best way to ensure your claims are clean of unbundling overpayments. A hospital finance department should not treat National Correct Coding Initiative (NCCI) edits as irrelevant to inpatient billing simply because payers don’t use the NCCI to edit inpatient claims before payment. Instead, hospitals should institute internal controls to ensure claims are ...