In Billing
Jul 19th, 2019
An Ambulatory Surgical Center Payment System (ASC PS) update that took effect July 1, 2019, changes billing instructions for various payment policies and codes. Here is what you need to know to properly bill Medicare for these services and supplies. New CPT Category III Codes Effective July 1, 2019, the Centers for Medicare & Medicaid ...
In Billing
Dec 13th, 2017
In case you were unaware of proper billing of services for Medicare patients in a covered Part A inpatient stay, here is a refresher. Medicare will not pay acute-care hospitals for outpatient services provided to patients in a covered Part A inpatient stay at another facility. This includes Medicare patients who are inpatients of long-term ...
Jul 29th, 2015
By Nancy Clark, CPC, CPC-H, CPB, CPMA, CPC-I While recently reviewing claims, I noticed an area of “undercoding,” or coding for a lesser procedure than is documented in the medical record. Upon review, this particular issue also appears as a repeat offender of the Comprehensive Error Rate Testing (CERT) program on several Medicare Administrative Carriers’ ...
In Billing
Feb 2nd, 2015
If you submit claims to Medicare, know that you have 45 days to respond to an Additional Documentation Request (ADR) that you receive from a Medicare administrative contractor (MACs) or Zone Program integrity contractor (ZPIC). According to MLN Matters® MM8583, “Failure to respond within 45 days of a prepayment review ADR will result in denial ...
Mar 1st, 2013
By Ida Landry, MBA, CPC Knowing coding and billing rules, and following them with integrity, is key to success. Compliance is an important part of medical coding. Novice coders are instructed early on that “correct coding is the No. 1 objective,” and “if it isn’t documented, it wasn’t done.” These rules of thumb are the ...