Dec 1st, 2012
By G. J. Verhovshek, MA, CPC You’ve probably heard of the “multiple procedure rule,” which reduces Medicare payment by 50 percent for the second and subsequent procedures provided to a single patient by the same physician on the same day. But did you know that a modified version of the multiple procedure rule may apply ...
In CMS
Oct 1st, 2012
Surgical modifiers are crucial to telling the story of a claim by identifying procedures that have been altered, without changing the core meaning of the code(s) submitted. Let’s focus on proper application and instructive resources for three surgical modifiers: modifier 50, modifier 51, and modifier 59. Modifier 50 Modifier 50 Bilateral procedure describes procedures/services that ...
Sep 1st, 2012
By G.J. Verhovshek, MA, CPC The Physician Quality Reporting System (PQRS) is a voluntary program that pays eligible professionals (EPs) (including Medicare physicians and select providers and therapists) who provide services to Medicare beneficiaries and report on approved quality measures. For 2012, the incentive equals 0.5 percent of the EP’s total estimated Medicare Physician Fee ...
Aug 1st, 2012
By Nancy Clark, CPC, CPC-I Modifiers are crucial in telling the story of the claim by identifying procedures that have been altered in some way without changing the core meaning of the code(s) submitted. Let’s look at the modifiers that can be appended to evaluation and management (E/M) codes used within the global period. The ...
In Billing
Dec 30th, 2011
The release of the 2012 Medicare Physician Fee Schedule (MPFS) final rule brings an expansion of the multiple procedure payment reduction policy for Medicare, as well as modifications to the Physician Quality Reporting System (PQRS) and other changes. Congress acted on Dec. 23, 2011 to stall a 27.4 percent cut in Medicare payments that would ...