In Billing
Jul 11th, 2019
The professional service of preparation and provision of antigens for allergen immunotherapy — reported using CPT® 95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses) — is often misunderstood and incorrectly coded and billed to third-party payers. This misunderstanding causes a ...
In Billing
Jul 8th, 2019
Free resources that will help you report provider services accurately. Due to productivity demands, medical coders may be tempted to rely on word of mouth for answers to coding questions, rather than to read guidelines, policies, rules, and instructions to substantiate coding decisions. Although seeking the advice of knowledgeable and experienced coders may be necessary ...
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 Audit
Mar 7th, 2018
Section-specific examples have been added to the Medicare National Correct Coding Initiative (NCCI) Policy Manual. These examples reveal the rationales behind the edits contractors use to vet medical claims for incorrect code combinations. Take the Initiative to Correct Coding The Centers for Medicare & Medicaid Services (CMS) implemented the NCCI to promote national correct coding methodolog...
Follow the correct edit to promote payment and avoid denial. By Samantha Prince, BSHCM, COC, CPC, CPMA National Correct Coding Initiative (NCCI) edits for Medicare and Medicaid are not the same. If you’re following Medicare edits for Medicaid claims, you may have claims denying inappropriately. That’s missed revenue you could capture by applying the correct ...