In Audit
Feb 20th, 2018
A specimen validity test performed on the same day as a urine drug test for the same person should be a rare occurrence because specimen validity testing is included in the description of HCPCS Level II codes for urine drug tests. Billing both tests separately is like double-dipping. And yet, Medicare paid 4,180 clinical laboratories and physician offices ...
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 ...
Not knowing the most current edits can cause costly coding errors. Each quarter, the Centers for Medicare & Medicaid Services (CMS) releases an updated version of the National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) edits and medically unlikely edits (MUEs). The NCCI Policy Manual for Medicare Services (Policy Manual) that explains many of these edits ...
Maximize revenue cycle profits by watching bundling. Becoming knowledgeable about National Correct Coding Initiative (NCCI) policies and edits may be the difference between having a profitable revenue cycle or placing your facility at risk for denials. In recent years, NCCI policies and edits have become key factors in outpatient facility and professional claims denials. You ...
In Billing
Jan 20th, 2017
If your accounts receivables are higher than expected in first quarter 2017, remember the old adage: If it’s too good to be true, it probably is. Due to errors in the Medicare Claims Processing System, some Outpatient Prospective Payment System (OPPS) hospital claims with dates of service on or after January 1, 2017, may have ...