In Billing
Dec 8th, 2017
Effective Jan. 1, 2018, modifier GT Via interactive audio and video telecommunications systems is no longer required on professional claims for telehealth services. Place of Service (POS) code 02 certifies that the telehealth service meets Medicare’s requirements for reimbursement. Get Telehealth Services Paid in 2018 POS code 02, finalized in the 2017 Medicare Physician Fee Schedule (MPFS) f...
In Coding
Oct 18th, 2017
Generally, wound care involves assessment and management of the wound, cleansing of the wound, simple debridement, and removal and reapplication of the wound dressings. In most cases, it is inappropriate to report an E/M service in addition to a wound care service (e.g., debridement, application of an Unna’s boot, etc.); however, if during the wound ...
In CMS
Jul 14th, 2017
Among the many provisions detailed within the 2018 Physician Fee Schedule Proposed Rule, released July 13, the Centers for Medicare & Medicaid Services (CMS) acknowledges that the current evaluation and management documentation guidelines create an administrative burden and increased audit risk for providers: Stakeholders have long maintained that both the 1995 and 1997 guidelines are ...
Healthcare expenditures account for an estimated 18 percent of the United States’ gross domestic product. A 2014 BMC Health Services Research study (“Billing and Insurance-related Administrative Costs in United States’ Health Care”) found that in 2012 billing and insurance-related administrative costs alone totaled $471 billion — nearly one-fifth of all healthcare costs. While I celebrate ...
In Coding
Dec 12th, 2016
Question: Can a physicians code separately for reading X-rays or imaging studies taken elsewhere? For instance, could we report the appropriate X-ray CPT® code with modifier 26 Professional component attached? Answer: If another provider (e.g., hospital radiologist) previously read/interpreted the image, and has issued a report, your physician cannot separately code or be paid for ...