In CMS
Nov 13th, 2018
Proton therapy has been a tough sell for payers, but recent $25 million Oklahoma decision against Aetna may make them reconsider coverage for the spreading radiation therapy technique. Proton Tx Considered Best Choice According to the Associated Press, jurors believed Aetna reckless disregarded its duty to deal fairly and in good faith with Orrana Cunningham.  ...
Here is what you need to know to avoid obsolete coding practices. Over the past few years, CPT® coding for spinal surgical procedures has changed significantly. Have you kept pace? Let’s double-check to make sure you’re still reporting correctly. Fusion Levels When it comes to counting fusion levels, it helps to remember the “cream filling” ...
Here is what you need to know about recent changes that will help you differentiate the two. The past few years have brought changes in CPT® and HCPCS Level II coding for presumptive toxicology screenings (screens) and definitive confirmations (confirms). Here’s what providers, billers, coders, and auditors need to know about these developments. Research and ...
Know CPT® critical care criteria and communicate the documentation rules to providers. Critical care services must meet specific criteria, per CPT® guidelines. But providers don’t necessarily define critical care in the same way CPT® does, and neither will they automatically document to support coding. Coders can help providers by communicating three documentation requirements for reporting ...
In understanding each other’s role in healthcare reimbursement, coders and CDI specialists make a dynamic duo. In healthcare, we can no longer work in silos, separate from each other, doing our own thing, unaware of what other staffers are doing. We must work collaboratively, as a team that extends past our own departments. Value-based healthcare ...