In Coding
Aug 16th, 2016
Noridian Healthcare Solutions is initiating a service-specific targeted review for mental health CPT® code 90834 Psychotherapy, 45 minutes with patient and/or family member. The Medicare administrative contractor (MAC) says data analysis has identified a potentially high use of this code in Jurisdiction E (California, Hawaii, Nevada, American Samoa, Guam, and the Northern Mariana Islands). Are ...
Oct 30th, 2015
Noridian Healthcare Solutions is initiating a service specific probe review for CPT® 70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contract material, followed by contrast material(s) and further sequences in jurisdiction E (California, Hawaii, Nevada, American Samoa, Guam, and the Northern Marian Islands). This is a perfect time for your practice, regardless ...
In Audit
Aug 29th, 2015
By Charla Prillaman, CPCO, CPC, CPC-I, CCC, CEMC, CPMA When we audit medical claims for accurate coding, modifier usage is usually included in the findings.  Inaccurate or inappropriate application of modifiers to CPT© codes could result in inaccurate (over or under) payment of claims. Additionally, there are times when application of a modifier following CPT© ...
In Billing
Feb 10th, 2012
Treatment of endometrial hyperplasia with the insertion of a hormone-containing intrauterine device (IUD) is an accepted method to manage endometrial hyperplasia for patients with abnormal uterine bleeding who are unable to tolerate, or at high risk for complications of, oral megestrol, states Palmetto GBA in its February 2012 Medicare Advisory. The jurisdiction 1 Medicare administrative ...
In CMS
Feb 15th, 2010
The Centers for Medicare & Medicaid Services (CMS) has clarified the pricing for Ozurdex (dexamethasone, intravitreal) when billed using HCPCS Level II code J3490 Unclassified drugs with a description of “Ozurdex” in Item 19 of the CMS-1500 claim form or its electronic equivalent. Ozurdex Pricing Update was last modified: July 5th, 2011 by admin aapc...