Nov 1st, 2018
Learn what’s in store for facilities billing under the Home Health Prospective Payment System in the coming years. For 2019, the Centers for Medicare & Medicaid Services (CMS) will recalibrate scores for the case-mix adjustment variables, clinical and functional thresholds, payment regression model, and case-mix weights using 2017 claims data. The 2019 market basket update ...
In Billing
Feb 23rd, 2018
Several new Medicare Learning Network (MLN) fact sheets offer tips on provider compliance for certain items that regularly appear on the Office of Inspector General Work Plan due to a high level of improperly paid claims. Here’s a quick synopsis. Hospital Beds and Accessories Physicians and other practitioners who write requisitions or orders for hospital beds ...
Q: What is the proper CPT® coding for Reclast® infusion? Reclast® requires a 30-minute hydration prior to administration. May we report this separately? A: Reclast® (zoledronic acid) is an infused medication used to treat osteoporosis and Paget’s disease of bone. The appropriate HCPCS Level II supply code for Reclast® is J3489 Injection, zoledronic acid, 1 ...
In Billing
Jan 16th, 2017
The 21st Century Cures Act, signed into law Dec. 13, 2016, changed the way certain Medicare Part B drugs infused through durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items will be paid beginning in April. Curing Improper Payments Section 5004 sets payment amounts for Part B drugs infused through DMEPOS items using the Average ...
When you know the bundling rules and how to report additional sites, coding is no longer a pain. For 2016, there are several additions to CPT® codes relating to paravertebral blocks (PVB): 64461 Paravertebral block (PVB) (paraspinous block) thoracic; single injection site (includes imaging guidance, when performed) +64462       second and any additional injection ...