In Billing
Aug 9th, 2019
January 1, 2020, marks the start of the Appropriate Use Criteria (AUC) program educational and operations testing period, at which time Medicare Administrative Contractors (MACs) will begin accepting AUC-related modifiers on claims for advanced diagnostic imaging services furnished to Medicare Part B patients. The voluntary participation period ends December 31, 2019. Know AUC Program Requirements ...
In Coding
Jun 1st, 2019
Ordering physicians will need to consult a qualified CDSM for advanced imaging studies — radiologist payment will depend on it. The Protecting Access to Medicare Act of 2014 (PAMA) mandated appropriate use criteria (AUC) beginning January 2017. This was in response to the rising cost of advanced diagnostic imaging studies including computed tomography, magnetic resonance ...
In Billing
Oct 23rd, 2018
An important update has been made to the Medicare National Coverage Determinations (NCD) Manual regarding coverage of magnetic resonance imaging (MRI) for patients with certain implantable cardiac devices. In a National Coverage Analysis (NCA), the Centers for Medicare & Medicaid Services (CMS) determined there is sufficient evidence to conclude MRI for patients with certain implantable ...
In Coding
Jun 6th, 2018
The answers to proper medical coding and reimbursement are not always transparent. From the referral to the claim submission, there are many opportunities for errors that result in a claim denial, improper payment, or even an audit. To secure proper payment, here is a checklist of five essential questions to ask yourself as you code ...
In CMS
Apr 18th, 2018
As of July, the Centers for Medicare & Medicaid Services (CMS) is making things easier for medical coders, billers, and implanted pacemaker and defibrillator patients to receive a magnetic resonance imaging (MRI) scan. Clarifying Pacemaker Language CMS said in a Decision Memo dated April 10 it intends to change the language of section 220.2 of ...