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 ...
Avoid payer denials by ensuring your provider or supplier follows the rules for allowable MUE units. Understanding why Medically Unlikely Edits (MUEs) were established, how they are organized, and the criteria on which edit rationales are based may help medical coders and billers avoid denials or, at a minimum, properly resolve a denial. What Are ...
In the absence of payer guidance, look to CMS and CPT® for guidance on reporting an E/M as a separate service from chiropractic manipulative treatment with modifier 25. Editor’s Note: Healthcare Business Monthly was recently asked about reporting evaluation and management (E/M) services separately from chiropractic manipulative treatment (CMT) of the spine. As with most ...
Learn vascular system anatomy and terminology to make reporting these procedures less challenging. A thorough understanding of the anatomy and medical terminology of the vascular system is required to accurately code arterial vessel procedures. Here’s a quick run-through of clinical information and coding guidance to show you how order affects coding. Order Matters Please refer ...
In CMS
Sep 21st, 2018
The Centers for Medicare & Medicaid Services (CMS) issued, Sept. 17, a proposed rule for revising several compliance requirements that have been identified as unnecessary, obsolete, or excessively burdensome on healthcare providers and suppliers of durable medical equipment. The proposed changes are in accordance with President Trump’s Jan. 30, 2017, Executive Order “Reducing Regulation and Con...