In Billing
May 31st, 2019
The Durable Medical Equipment Medicare Administrative Contractors (DME MAC) are changing the requirement that medical coders to use the right (RT) and left (LT) modifiers for certain HCPCS codes, and that the modifiers be used when billing two of the same item or accessory on the same date of service and the items are being ...
In Audit
Mar 6th, 2019
If  you receive Additional Documentation Requests (ADR) from a Medicare Administrative Contractors (MAC) and others, here are some tips  to respond most effectively. Additional Documentation Request Success Isn’t that Hard CGS  Administrators, a MAC and Durable Medicare Administrative Contractor (DMAC) with a presence in 38 states, offers helpful tips in their ADR process.  ADRs may ...
To better understand the three types of anesthesia rewire your thinking with this telephone analogy. Have your every wondered how anesthesia works? I have. But then a certified registered nurse anesthetist (CRNA) explained it to me so clearly that I felt compelled to share her analogy with other medical coders. To better understand how the ...
In Audit
Mar 4th, 2018
The Centers for Medicare & Medicaid Services (CMS) calculates the Medicare Fee-for-Service (FFS) improper payment rate through the Comprehensive Error Rate Testing (CERT) program. Every year, CERT evaluates a statistically valid stratified random sample of claims to determine if they were paid properly under Medicare coverage, coding, and billing rules. A dispute may be filed ...
In Billing
Jan 18th, 2018
Palmetto GBA is preparing to become the A/B Medicare administrative contractor (MAC) for Jurisdiction J (JJ), which includes the states of Alabama, Georgia, and Tennessee — and so should you if you submit Medicare claims for healthcare providers who practice in those states. Part A providers will transition from Cahaba GBA effective Jan. 29, 2018, and Part ...