[QUOTE="amyjph, post: 510300, member: 172045"]
CMS has a tutorial on ABNs: [URL]https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/ABN-Tutorial/formCMSR131tutorial111... [ Read More ]
CMS has a tutorial on ABNs: [URL]https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/ABN-Tutorial/formCMSR131tutorial111915f.html[/URL]
[URL unfurl="true"]https://www.... [ Read More ]
I was told during a Novitas webinar the following regarding coverage:
A procedure can have other policies or guidelines besides an LCD (not an all inclusive list of places to check):
1)MAC website
*L... [ Read More ]
[QUOTE="RDK720, post: 455046, member: 294553"]
Hi. This is from Noridian.
Another point, if the provider is requesting to change or changes the EHR [U][B]AFTER[/B][/U] submission of the claim, this w... [ Read More ]
Hi. This is from Noridian.
Another point, if the provider is requesting to change or changes the EHR [U][B]AFTER[/B][/U] submission of the claim, this would constitute fraud.
[SIZE=6][B]Documentat... [ Read More ]
[QUOTE="smithca, post: 437962, member: 60457"]Can a social worker (LCSW-R) bill cpt code 96150? I have conflicting information that says yes then can and other information that says only a clinical p... [ Read More ]
[b]Z01.818; Z12.11 seems inappropriate to justify an E/M visit.[/b]
I have a similar situation whereby the doc is billing for a preop to a screening colonoscopy.
No other conditions are addressed.
I... [ Read More ]
This is from WPHGHA LCD policy L35761
Utilization Guidelines
Each patient’s condition and response to treatment must medically warrant the number of services reported for payment. Medicare requires... [ Read More ]
0275T is for a percutaneous approach
62287 is for needle based approach for removal of disc material
62380 is an endoscopic approach for laminotomy/discectomy
63030 is an open approach/direct visualiz... [ Read More ]
As pertains to the E&M visits your concerned with, the usual reference for this is from the Medicare Claims Processing Manual, Chapter 12, see section 30.6.1, linked below: [I]"Medical necessity of a... [ Read More ]
Know where to find the proof you need to support your coding billing or auditing. As a medical auditor biller or coder you cant expect a physician to take kindly to you telling them how they need to d... [ Read More ]
The quality of evaluation and management documentation is paramount for clinician reimbursement. Evaluation and management EM services are the most vulnerable to billing errors because it is complicat... [ Read More ]
Know what payers are looking for in subsequent hospital care claims and how to give it to them. Medical necessity is the No. 1 consideration when selecting an evaluation and management EM service code... [ Read More ]
Ensure your home visits are medically necessary and meet payer billing requirements. By Beth Schleeper COC CPC CPB CPCO CPMA CPPM CPCI CEMC AAPC Fellow As a patient having a physician come to your hom... [ Read More ]
Four best practices when following radiology compliance regulations. By Kim Wells CPC CPMA CEMC AAPC Fellow The issue of healthcare fraud and abuse has attracted a lot of attention in recent years pri... [ Read More ]
