In Coding
Jun 6th, 2018
Part 1: Educated coders and providers are crucial to claim success. Delivering quality care, while ensuring effective clinical documentation and compliant medical coding, is an ongoing challenge in a fast-paced emergency department (ED). Over the next two months, we’ll review best practices to optimize coding compliance and reimbursement of ED claims. In part 1 of ...
In Billing
May 23rd, 2018
Here’s a summary of the changes for the July update to the 2018 Medicare Physician Fee Schedule Database (MPFSDB). Changes are effective for dates of service on and after July 1, 2018. Indicator Change for RHC and FQHC Care Management Codes For the following two HCPCS Level II codes, the PC/TC indicator is changed to 0 (zero) ...
In CMS
May 17th, 2018
The Advancing Care Information (ACI) performance category – one of four performance categories in the Merit-based Incentive Payment System (MIPS) – is now the Promoting Interoperability (PI) performance category. What’s In a Name? For whatever reason, the Centers for Medicare & Medicaid Services (CMS) renamed the performance category. Nothing else has changed about the category. ...
In CMS
Jan 18th, 2018
The 2016 Value Modifier (VM) performance results and 2018 payment adjustment factor are now available: Out of over 1 million clinicians, only approximately 20,000 will see an upward VM payment adjustment in their Medicare Physician Fee Schedule (MPFS) payments this year. This may not be a good time to ask for that raise. Table A shows ...
In Coding
Dec 4th, 2017
The Centers for Medicare & Medicaid Services (CMS) finalized in the 2018 Medicare Physician Fee Schedule (MPFS) final rule their proposal to remove oxygen gas supply item (SD084) from a series of CPT codes that were previously valued with moderate sedation as an inherent part of the procedure. It occurred to CMS, after finalizing the ...