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 ...
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 29th, 2018
Remember back in 2015 when CPT® changed the definition of an incomplete colonoscopy from one that does not evaluate the colon past the splenic flexure to one that does not evaluate the entire colon? The Centers for Medicare & Medicaid Services (CMS) is responding to that change, albeit rather lethargically. Incomplete Colonoscopies, by Definition CPT® 2015 ...
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 ...
Oct 10th, 2018
UnitedHealthcare (UHC) has issued a clarification to its Skin and Soft Tissue Substitutes medical policy (2018T0592A) in regards to DermACELL®. Behind the Decision DermACELL® (LifeNet Health®) is advanced human acellular dermal matrix intended for the treatment of chronic wounds and soft tissue reconstruction such as implant-based breast reconstruction. A recent report for DermACELL concluded that ...