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Part B Insider (Multispecialty) Coding Alert

CCI 13.0:
You Can No Longer Use A Modifier To Override Nursing Facility Edits
Contact your carrier now to overturn denials of 29999 and other codesCorrect Coding Initia... Read more
ENROLLMENT:
Revalidate Your Enrollment Information Now, To Avoid Hold-Ups Later
One carrier has 12,200 applications in backlogWatch out: A new clog in the Medicare physic... Read more
CPT 2007:
New Anesthesia, Stereotactic Radiosurgery Codes On CCI's Hit List
You can't use a modifier to override SRS editsCPT 2007 brings a number of new procedure co... Read more
Musculoskeletal Surgery:
You'll Need Fancy Footwork To Bill Anything With New Spinal Surgery Codes
CPT 2007 introduces a number of new codes into the musculoskeletal section, so it's not su... Read more
CCI 13.0:
More New Edits You'll Have To Master
Digestive system surgery, female genital system among top targetsCrunch time: Start learni... Read more
CPT:
6 Steps Promise Diabetes Coding Success
Complications need special attentionDiabetes refers to diabetes mellitus or, less often, t... Read more
CARDIOVASCULAR SURGERY:
Watch Out--Your New Cardio Codes May Have Strings
A modifier won't rescue you from edits on 33254-33256Your new cardiovascular surgery codes... Read more
Part B Coding Coach:
Hone Your Modifier 25 Policy With These Guidelines
Private payors may drop the modifier requirement for medicine/service claims You fina... Read more
PHYSICIAN NOTES:
Call Your Vendor Now To Get Started On Quality Reporting
You'll start the year with no change to your paymentsGood news: Congress acted at the very... Read more
Reader Question:
Every Minute Counts With 8-Minute Rule
Question: Under Medicare's eight-minute rule for billing timed CPT codes, how should I rep... Read more
REIMBURSEMENT:
You May Not Have To Cut Costs Next Year After All
But you could have incentives to report quality informationGood news: Congress moved at th... Read more
GENERAL SURGERY:
Your Abdominoplasty Claims Face More Hoops In 2007
CMS makes new code 15830 carrier-pricedPerhaps you were hoping for a new era of streamline... Read more
PART B MYTH BUSTER:
Don't Fall Into A Trap Over Overusing MDM For New Problems
Complex decisions aren't always the deciding factorMyth: You must always include medical d... Read more
ASCs Could Soon Have New Payment System
If your physician owns or runs an ambulatory surgery center (ASC) you could soon have a ne... Read more
COMPLIANCE:
Beware--OIG Cracks Down On Physical Therapy Billing
Doctors go to prison for underdosing, falsifying records--even murderYour physical therapy... Read more
Consults, Drugs Still On OIG Radar
The OIG also recapped some of its most important reports from the past year:Consults: Medi... Read more
RECOVERY AUDIT CONTRACTORS
RACs still hunting for physician waste in three statesThe so-called Medicare -bounty hunte... Read more
Part B Coding Coach:
Coding Quiz--How Much Do Your Really Know About ABNs?
Demystify modifiers GA, GY and GZ You use advance beneficiary notices (ABNs) to let b... Read more
PHYSICIAN NOTES:
OIG Gives Gainsharing Okay, But Concerns Remain
Radiologists could soon have to meet standardsYour doctors can go ahead and make cost-shar... Read more
NPIs:
Get All Your Ducks In A Row When You Apply For An NPI
Don't leave your application until the last minuteIf you-ve been waiting to get a national... Read more
PART B MYTH BUSTER:
4 Myths About 99211
Don't use level 1 visit for all vaccinations and allergy shotsMany physician coders are co... Read more
NPIs:
Don't Let Out-Of-Date Software Keep You From Using NPIs
Contact your vendor now to make sure you'll be up to speedA patch could keep your billing ... Read more
MEDICALLY UNLIKELY EDITS:
Contact Your Carrier Before Submitting Anatomically Unlikely Claims
Anatomic edits will be the first to take effect in JanuaryBrace yourself: Beginning in Jan... Read more
COMPLIANCE:
Take A Gook Look At Your Doctors' Investments In Device Makers
OIG has a bee in its bonnet about doctors investng in devicesLike the tycoon in the old Re... Read more
Part B Coding Coach:
Get Straight Answers to Your MBS Billing Questions
A good team effort between an SLP and a radiologist is not a bad thingYou no longer have t... Read more
PHYSICIAN NOTES:
AMA Calls On Congress To Avert 5-Percent Cut Before It's Too Late
AMA has developed 151 quality measures for doctorsThe American Medical Association (AMA) k... Read more
E/M CODING:
You Can Bill A 99214 With Exam Of Only 2 Body Areas Or Systems
But don't assume you have a 99214 just because you have 5 or moreAre you a victim of the -... Read more
PART B MYTH BUSTER:
A Consult Shared Is A Problem Doubled
Pay attention to CMS clarificationMyth: You can have a nurse practitioner (NP) or physicia... Read more
Medicare Does A Better Job Of Collecting Documentation From Providers
The federal government spent $7 billion less in improper payments in 2005 than in 2004, ac... Read more
E/M CODING:
How To Make Sure Your 99214s Measure Up
Look for more detailed statements, extra elementsYou can't rely on the number of organ sys... Read more
NEUROSURGERY:
Coder Wins Back $300,000 For Neurosurgery Practice
Don't take spine decompression denials lying downYou may have won out over edits that made... Read more
PSYCHIATRIC CODING:
If Your Patients Take Psych Meds, Consider 90862 For Management
Check with your carrier about 90862 coverageMost non-psychiatric physicians shy away from ... Read more
Part B Coding Coach:
3 Tips To Cleaning Up 76 & 77 Slipups Before They Cost You Big Bucks
Learn CMS' rule for procedures performed 3 times in 1 day.Payors may think you made a typo... Read more
Clip and Save:
These 8 Services Are Not Part Of The Global Surgical Package
If your not reporting these services separately, you're losing moneyIt can be hard to keep... Read more
PHYSICIAN NOTES:
Your Doctor Can Make A Big 'HIT' With ACPs Help
Register now for course starting in JanuaryWant to get your physician up to speed on healt... Read more
PART B MYTH BUSTER:
Don't Throw Away Money For Antiemetic, Immunosuppressive Drugs
The key: Obtain a DME billing numberMyth: You can't bill Medicare for any oral medications... Read more
RADIATION THERAPY:
Double Your Reimbursement By Noting When Radiation Therapy Is Twice Daily
A 'week' may be two and a half daysThink you can't bill radiation therapy twice a day? Thi... Read more
REIMBURSEMENT:
Democratic Landslide Means Congress May Let Your Payments Slide
The longer they wait, the worse your prospects areBrace yourself: It could be March, or ev... Read more
Primary-Care Docs Fall Behind in Electronic Records
Only 28 percent of primary care physicians (PCPs) in the United States (and 23 percent in ... Read more
PE-RVUS:
Your Female Patients Could Suffer From New PE-RVU Cuts
Some specialties reap massive pay increases, others sufferBrace yourself: Some services wi... Read more
WORK RVUS:
Cardiologists, Dermatologists Regain Some Value In Work RVUs
Medical nutrition therapy will finally have Medicare paymentsYou work hard for the RVUs--a... Read more
Part B Coding Coach:
Clamp Down On Incident-to Errors In Your Claims
Master the rules of this OIG hot buttonDon't let the tricky nature of -incident-to- claims... Read more
PHYSICIAN NOTES:
Let The Sanction Fit The Crime For HIPAA Privacy Violations
Make sure you know what your organization considers a privacy violationIt's up to you to d... Read more
REIMBURSEMENT:
Brace Yourself For A Bumpy January
Good news: Expect a boost in E/M reimbursement despite blanket cutsYour Medicare reimburse... Read more
CARDIOTHORACIC:
Navigating New Maze Codes Leaves Coders Right Back Where They Started
CPT 2007 makes it almost impossible to bill  33254-33256You may have celebrated new m... Read more
CMS Can't See Coverage For Infrared Therapy
Medicare won't cover infrared therapy devices for treatment of diabetic and non-diabetic s... Read more
GENERAL SURGERY:
New Skin Codes Could Fit You Like A Second Skin
Anatomic location is now a factor for graft preparationYou could soon be reaping more reim... Read more
Don't Shut Your Condo Labs Just Yet
Good news: For now, the Centers for Medicare & Medicaid Services (CMS) won't go ahead ... Read more
PART B MYTH BUSTER:
Patient May Be New To You--But Not Necessarily New In Medicare's Eyes
Check your billing records for tax IDs, past visitsMyth: If your doctor hasn't seen a pati... Read more
Is The Patient 'New'? Answer Correctly Every Time
These 5 questions pinpoint patient's status Take the American Medical Association's adv... Read more
PAIN MANAGEMENT:
Don't Report New Postoperative Pain Codes If You Have A Specific Diagnosis
New guidelines clarify fracture care coding Confused about new postoperative and chronic p... Read more
Part B Coding Coach:
Learn The Do's & Don'ts Of Deciphering 99213 and 99214
Make sure your upcoding practices are on the up and up with these 3 tipsPayors audit 99214... Read more
PHYSICIAN NOTES:
CERT Program Certified With Clean Bill Of Health
Carriers must look at all diagnosis codes on a claimThe Centers for Medicare & Medicai... Read more
PART B MYTH BUSTER:
Don't Charge Patient For Preventive Services Without Checking Secondary Coverage
Obtain a denial from Medicare so the claim can cross overMyth: You can't bill for a preven... Read more
OFFICE MANAGERS:
Fire Your Patients--Without Getting Burned
5 tips to avoid legal pitfalls in discharging deadbeat beneficiariesDelinquent patients do... Read more
GENERAL SURGERY:
Rectal Mucosectomy May Have Become Harder To Bill
But you can stop using an unlisted code for gastric electro stimulationIt looks as though ... Read more
DERMATOLOGY:
New Moh's Codes Could Spell Body-Part Bias--And Denials
Make sure your carrier revises its local coverage determinationsSometimes more specific co... Read more
NPPS:
Manual Misprint Leads To Missed Reimbursement For NPs
Don't take denials lying down, contact CMS nowIf your practice is seeing denials for nurse... Read more
Part B Coding Coach:
Crack Down on Fee-Reducing Modifier 52 Mistakes
Do you know the CMS rule for partial S&I services?If you automatically append modifier... Read more
Reduce Modifier 52 Stress With This TrailBlazer Advice
The Texas Part B provider offers some documentation clarificationExpect a denial if your m... Read more
PHYSICIAN NOTES:
Quality Measures Could Explode Next Year, CMS Says
Solo practices can receive bonuses for quality soonPhysician quality reporting may not be ... Read more
CPT 2007:
Coumadin Clinics Will Welcome New Anticoagulant Codes
Inpatient consult codes lose confusing 'initial' labelYou-ll have two new codes to report ... Read more
RADIOLOGY:
Category III Codes For Stereotactic Therapy A Thing Of The Past
You can start billing for CT and MR needle-placement guidanceGood news: Instead of the two... Read more
ORTHOPEDICS:
Total Disc Arthroplasty Gets Totally New Codes
Say goodbye to unlisted codes for IDET, extensor tendon excisionYou can finally stop billi... Read more
CARDIOLOGY:
CMS Provides A New Map For The Maze Procedure
Old pacemaker insertion codes replaced with electrode codesIf your surgeon has been provid... Read more
Legal Fears Keep Doctors From E-mailing Patients
Fewer than 4 percent of physicians communicate via e-mail with their patients, according t... Read more
PART B MYTH BUSTER:
Make Sure Same-Day Admit And Discharge Are Both Face-To-Face
To get it right, don't forget to note separate facility addressesMyth: You can't bill for ... Read more
Don't Lose Reimbursement By Overlooking New Moh's Surgery Codes
Prepare now for a big change in how you code your dermatologist's Moh's micrographic surge... Read more
Part B Coding Coach:
Avoid Modifier 25 When Your Cardio Procedure Lacks A Global Period
Find out why this clarification is good news for your practiceJust because auditors are ta... Read more
PHYSICIAN NOTES:
You Could Receive Pay Boosts Of Up To 3-Percent Per Year
Current system doesn't account for drug discounts you never seeIf you took away all the mi... Read more
REIMBURSEMENT:
Physician Offices Still Defrosting From 9-Day Medicare Freeze
Daily billing, early appeals helped cushion the blowThe worst nine days of the year are ov... Read more
CARDIOLOGY:
Make Sure Your Carrier Accepts Q9775 For Definity
Carriers won't cover Definity if they deny the echocardiogram Watch out: Many pro... Read more
REIMBURSEMENT:
Some republicans skeptical of forcing you to jump through quality hoops
Some Republicans skeptical of forcing you to jump through quality hoopsYou could face a 12... Read more
ENROLLMENT:
Read The Fine Print Before Your Doctor Signs New 855I
You could be enrolling in a world of hurtIf your practice's compliance plan isn't up to sn... Read more
Norwalk Replaces McClellan At CMS
Leslie Norwalk has been named the acting chief of the Centers for Medicare & Medicaid ... Read more
COMPLIANCE:
OIG Zeroes In On Incident-To Billing
Prepare for more scrutiny of your ASC and PT billingNow's the time to review all of your -... Read more
Part B Coding Coach:
Protect Modifier 59 Payments Using These Strategies
Find out 2 ways the OIG says coders are making big mistakesNow is not the time to be lax i... Read more
PHYSICIAN NOTES:
U.S. Faces Primary Care Physician Shortage Within 14 Years
Former WHO head faces fraud chargesTo meet the United States- growing health care needs, t... Read more
ORTHOPEDICS:
DME Bidding Could Have Your Patients Limping Home
CMS will soon clarify NPI muddleThe next time a patient leaves your office wearing a cast ... Read more
RADIOLOGY:
Once Again, CCI Makes Radiology Coding A Minefield
Don't bill 75893, 36500 with many angiography codesOctober's Correct Coding Initia-tive (C... Read more
TESTS:
If The Test Comes Up Negative, You Must Bill Symptoms
Don't saddle your patients with a wrong diagnosis foreverWhen your physician orders a test... Read more
You've Got No Mail, Doctors Tell Patients
Only one in four doctors (24 percent) use e-mail to communicate with patients about their ... Read more
RADIATION ONCOLOGY:
Critical Care, Nursing Facility Care Bundled With Radiation Treatment
Your reimbursement for radiation therapy will be slashed by editsRadiologists just can't s... Read more
Deleted Edits:
They're Not All Bad News
CCI Version 12.3 doesn't just drop new edits on your head. It also offers relief by taking... Read more
CCI EDITS:
Say Goodbye To Modifiers For Nursing Facility Edits
Prolonged services, moderate sedation edits also modifier-proofA new set of 36 mutually ex... Read more
Part B Coding Coach:
Brush Up on Your ICD-9 Skills Before the 2007 Codes Hit
Follow these tips and guarantee proper diagnosis coding practices Choosing the right ... Read more
PHYSICIAN NOTES:
Time Running Out For Fix To 5.1 To 5.1-Percent Cut
You gave your carrier high marks for claims processingThe American Medical Association's $... Read more
REIMBURSEMENT:
Fight Against 5.1 Percent Cut Begins With Time Already Running Out
Physician spending grew much less quickly than expectedThere's no time to lose to save Med... Read more
ORTHOPEDICS:
Say Goodbye To 50-Percent Pay Cut For G0289
Medicare changes multiple procedure indicator for arthroscopyYou can look forward to $48 m... Read more
PE-RVU Changes Could Cut Major Procedures By 10 Percent
If the Centers for Medicare & Medicaid Services goes ahead with plans to change how it... Read more
REIMBURSEMENT:
Can A Lame Duck Save You From The Chopping Block?
Congress considers plan that would keep 5-percent cuts for some doctorsForget pay-for-perf... Read more
AUDITS:
Don't Start Auditing Your E/M Visits Without A Baseline
Follow up with problem doctors every few monthsSometimes you can have a problem with your ... Read more
DERMATOLOGY:
Getting Paid For Simple Repairs Isn't Always Simple
Don't give up on reimbursement for G0168Sometimes the carriers move in mysterious ways--an... Read more
Part B Coding Coach:
Don't Miss This Chance to Improve Your Practice's Coding Accuracy
Self-audits are well worth the time, experts sayAlthough some coders believe that self-aud... Read more
Clip and Save:
Let This Self-Audit Checklist Be Your Guide
Consider 9 criteria when you sit down with your audit materials If you don't know... Read more
PHYSICIAN NOTES:
Radiologists, Beware--CMS Is Looking For Double Billings
Utah Court Takes Managed Care Antitrust Claim With A Grain Of SaltRadiology providers bill... Read more
MEDICARE SECONDARY:
Avoid The Last-Minute Scramble For Secondary Claims Transition
Carriers may grant extension, vendors may be able to helpIf you haven't already received a... Read more
WOUND CARE:
Learn The Rules For Billing Repairs With Dermabond
Add $50 to your repair billing by capturing "dirty" woundsIf your physician is using Derma... Read more
MODIFIERS:
Warning--Don't Use 22 Modifier Unless You Can Show Extra Work
It's not enough to document previous procedureHeads up: A clarification of the 22 and 51 m... Read more
McClellan Stepping Down
Say goodbye to Mark McClellan as administrator of the Centers for Medicare & Medicaid ... Read more
MEETINGS:
PPAC To CMS--Stop The 10-Percent RVU Cut
Conversion factor still faces 5.1-percent cutThere's still time to stop a steep 10-percent... Read more
CCI EDITS:
Are You Missing Out On Critical Care Reimbursement?
2 CCI changes that should change the way you codeIf you-re not keeping up with the latest ... Read more
Part B Coding Coach:
Call on 22 if Your Surgeon Goes the Extra Mile
22 means more work for coders, too--but the payoff can be worth itWith appropriate documen... Read more
PHYSICIAN NOTES:
Update Your Notes On Several CPT Codes For The Fall
CMS makes changes to assistant at surgery indicatorsYou can no longer bill for an assistan... Read more
E/M CODING:
Hail To The Chief Complaint--Even If It's At The End Of The Note
Avoid vague phrases like 'patient feeling better'Getting dinged on audits because you don'... Read more
ONCOLOGY:
Don't Miss Out On Extra Mammogram Reimbursement
You can bill a unilateral screening mammography, carrier saysHeads up: One carrier has cla... Read more
CONSULTS:
CMS May Soon Untangle Consult Confusion
It's not a consult if the requesting physician 'doesn't give a rip'Good news: Your cries f... Read more
Obesity And Chronic Disease Drive Medicare Growth
The rate of obesity among Medicare patients doubled from 1987 to 2002--but spending on tho... Read more
REIMBURSEMENT:
Step Carefully When NPPs Bill For Consults
Don't let a doctor duplicate an NPPs decision-making, carrier warnsCan nurse practitioners... Read more
Feds Net Half A Million For Non-Covered Drugs
Watch out: Don't bill Medicare for Part B drugs unless you can prove that your physician a... Read more
WOUND REPAIR:
Learn Exceptions To Tissue Repair Rules--Or Pay
If the patient needs tendon repair, you can't bill for wound careDo you know the exception... Read more
Write A Part D Diagnosis On Prescriptions To Avoid Hassle
You should have less trouble from now on when a drug could be covered under Part B or Part... Read more
Part B Coding Coach:
Don't Sell Yourself Short In Timed Therapy Coding
Tip:  Focus on the total treatment time With our expert interpretation of the la... Read more
QUIZ:
Take This Timed Therapy Test
Question: Now that you have reviewed CMS- explanation of how to code timed therapy, see if... Read more
CLIP N' SAVE:
Get Your Therapy Code Units Right With This Simple Tool
Timed therapy codes can be confusing, but don't give in. Use this chart to determine how m... Read more
PHYSICIAN NOTES:
Bush Calls For Info Gathering, Doesn't Cover Costs
You may have to provide pricing data to the government next yearAs promised, Presiden... Read more
REIMBURSEMENT:
9-Day Delay May Turn Into 12 Days
Prepare now for slow end of SeptemberYou-re already bracing for the nine days of pain in l... Read more
STRATEGY:
Beware of Buying Equipment Before Ensuring Reimbursement
Don't let manufacturers snow you into investing in new gadgetsYou-ve heard other offices r... Read more
E/M CODING:
Make Sure Your Doctor Lists A Chief Complaint
No symptoms doesn't mean no reason for the patient to be thereIf your doctor is in the hab... Read more
More Tips On Handling The 9-Day Payment Freeze
Your cash flow will be hit hard in late September, when Medicare puts the brakes on paymen... Read more
COMPLIANCE:
Now's The Time To Look Into Your 'Pod Labs' Arrangements
CMS may have evicted you from 'condo' laboratories In recent years, many urol... Read more
Case Goes To Trial Because Doctor Didn't Document Recommendation
Good documentation doesn't just get paid, it can keep you out of trouble. Case in point: P... Read more
COMPLIANCE:
Don't Rush Into Opening A Single-Specialty Hospital
End of moratorium doesn't mean a ceasefire in war on doc-owned hospitalsYou may have rejoi... Read more
Part B Coding Coach:
Revealed--The Answers to Your Top 4 TURP Coding Questions
Want to know what you can bill with your transurethral resection of prostate claims? ... Read more
Make Your TURP Code Selection A Snap With This Flow Chart
Step-by-Step instructions make TURP coding a breezeIf you-re looking for an easy way to de... Read more
PHYSICIAN NOTES:
Medically Unlikely Edits Are Back
2,800 edits target 'non-controversial' topicsA drastically unpopular set of edits is back ... Read more
REIMBURSEMENT:
Brace Yourself For 5.1 Percent Cut Next January
Multiple imaging scan discount won't rise next year after allIt's worse than you-ve feared... Read more
COVERAGE:
Billing 69210 For Simple Ear Lavage Doesn't Wash
Carriers come out with strict policies on cerumen removalIf you-re billing cerumen removal... Read more
GLOBAL DAYS:
Watch Out For Retroactive Denials Of Same-Day E/M Visits
Make a spreadsheet of your common procedures and their global periodsMinor procedures may ... Read more
2 Key Global Period Tips
Confused about global periods? You-re not alone. Carol Pohlig, a senior coding and educati... Read more
COMPLIANCE:
Respond To Surveys--Or Face $10,000 Per Day In Fines
Doctor-owned hospitals risk having to cough up $12 million in penaltiesMedicare finally en... Read more
Medicare Turns E/M Coding Upside Down
Your hospital-based evaluation and management coding could change drastically next year. T... Read more
REIMBURSEMENT:
You Can Bill For Casting Supplies, Nutrition Therapy Next Year
More changes in the 2007 physician fee scheduleYour reimbursement for casting and splintin... Read more
Part B Coding Coach:
Guest Columnist: Annette Grady, CPC, CPC-H, CPC-P,)S--Avoid These Common ASC Coding Mistakes Or Face Denials
If you're new to surgery center coding, make modifier SG your friendAny orthopedic coder w... Read more
PHYSICIAN NOTES:
Gear Up To Provide Quality Measurements To Government
President plans technology standards for health care providersYour quality and outcomes co... Read more
REIMBURSEMENT:
Are You Prepared For What 2007 May Bring?
Here's your checklist of what the future really holdsThese are the times that try coders- ... Read more
NEUROLOGY:
Don't Despair On MRA Coding--Help Is Here!
Look for retired local policies, carrier manual for helpIf you-re tearing out your hair ov... Read more
REIMBURSEMENT:
Look Ahead To Proposed Payment Changes--You Could Change The Future
Don't wait until these proposals become final to make your voice heardNow's the time to sh... Read more
NEUROSURGERY:
Spine Surgery Practices--Gather Documentation Now For October Refunds
CCI edit revocation is retroactive to AprilSpine surgeons showed some backbone--and the re... Read more
Medicare Growth Shrinks--But More Cuts On The Way
The growth rate in Medicare spending -slowed considerably- during the period from 1992 to ... Read more
COMPLIANCE:
You Could Soon Get Help Upgrading Your Computer Systems
CMS, OIG loosen up on donations of e-prescription, EHR systemsHospitals will be able to do... Read more
Part B Coding Coach:
Are You Using the 22520 Series When Your Surgeon Performs Kyphoplasty?
Get up to speed with these 4 tips With the addition of three new kyphoplasty CPT codes in... Read more
Guest Column by Henry II, Barnard, M.D.:
Know The Differences Between Vertebroplasty and Kyphoplasty, And Correct Codes Will Follow
Hint:  Look for key terms in the surgeon's notes to identify kyphoplastyAccording to ... Read more
PHYSICIAN NOTES:
Will Your Computers Be Able To Talk To Each Other?
House and Senate set to hash out fate of health ITStay tuned: You could be facing a tight ... Read more
REIMBURSEMENT:
Can You Afford To Serve Medicare Patients Next Year?
Fixing problems could cost $218 billion, CBO warnsContact your Congress member: You should... Read more
CARDIOLOGY:
Avoid The 3 Deadly Sins Of Arterial Stent Documentation
Challenge the results of improper auditsIf your arterial stent documentation isn't up to s... Read more
AUDITS:
Don't Try To Stall The Medicare 'Bounty Hunters'
Learn which procedures are catching the eyes of the RACsSurgical practices, beware: The Re... Read more
AMA Announces November CPT Agenda
The changes to CPT 2007 won't be announced until this fall, but the first hint came out wi... Read more
CCI EDITS:
You Still Can't Bill For Lesion Excisions With Tissue Transfers
CCI restores troublesome general surgery editsIf you-re billing for lesion excisions (1140... Read more
Medicare Not Prepared For P4P, Congress Warns
Medicare shouldn't rush into implementing pay-for-performance, members of Congress insiste... Read more
STUDIES & SURVEYS:
GAO To Doctors--No Pay Increases? No Problem!
OIG beating the drums for drug pay cutsYour payments from Medicare have stayed stagnant si... Read more
NEUROLOGY:
Don't Put The Code Before The Cause For Carpal Tunnel
Use 354.0 only when completed testing confirms the diagnosisEven when a physician suspects... Read more
PODIATRY:
Tread Carefully When Reporting Ankle, Foot Strapping
You may not be able to bill 29540 by itself If you report 29540 (Strapping; ankle and... Read more
ORTHOPEDIC:
Face Up To Facet Injection Code Rules With These Clues
Hint:  Select the proper code based on injection siteProper coding for facet injectio... Read more
GASTROENTEROLOGY:
You Be the Coder--Look For 2 Little Words To Focus Your Colonoscopy Coding
Hint:  The device used doesn't determine the procedure codeQuestion: When performing ... Read more
CARDIOLOGY:
Turn Inconclusive Test Findings Into Conclusive Reimbursement With This Tip
Helpful:  Cover your bases and have patients sign an ABNIf you receive documentation ... Read more
Part B Coding Coach:
Take The Heat Out Of Your Burn Treatment Claims
Knowing the burn size is the first step to coding successLook out:  The burn treatmen... Read more
Rely On 'Rule of Nines' For Burn Dx
Before you can select the appropriate burn treatment procedure code from the 16000 series,... Read more
PHYSICIAN NOTES:
Brace Yourself For ICD-10 Transition By 2010
Doctor who followed carrier advice not guilty of false claimsYou may have to transition to... Read more
OTOLARYNGOLOGY:
Contact Your Carrier Now To Ensure Apnea Coverage
Don't let 'mental health' edits drive you up the wallIt's been a year since the ICD-9 upda... Read more
OTOLARYNGOLOGY:
Differentiate Between OSA And CSA--Or Face Denials
Treatment options for OSA and CSA will be very differentDo you know the difference between... Read more
GASTROENTEROLOGY:
Get Your Carrier's Colonoscopy Instructions In Writing
Medicare carriers' instructions are 'against HIPAA,' official warnsThe Part B carriers and... Read more
Steep Imaging Cuts Could Be Delayed By 2 Years
Imaging scans such as CT angiography to examine heart arteries or PET/CT exams to pinpoint... Read more
ASC CODING:
2 Secrets To Successful ASC Coding
Pay attention to modifier differences in ASC settingIf your physician is opening an Ambula... Read more
TRANSMITTAL ROUNDUP:
You Can Appeal Enrollment Denials To An ALJ
Learn how to fight billing revocations all the way to courtYou should be prepared for some... Read more
Part B Coding Coach:
Don't Fear Modifier 25 Audits--Arm Yourself With Top-Notch Documentation
Hint:  If E/M services go 'above and beyond' pre-op work, you can reportThe Centers f... Read more
PHYSICIAN NOTES:
Call Your Senator To Urge 2007 Pay Hike
Your payments have been frozen since 2001, Senators noteIf Congress doesn't get its act to... Read more
GENERAL SURGERY:
Look To Anatomy To Capture All Reimbursement For Colectomies
Don't miss out on splenic flexure, removal of internal ileum Watch out: You could... Read more
EVALUATION & MANAGEMENT:
Avoid Observation Denials By Using POS 22
State law may govern whether a patient is inpatient or outpatientCoders often become confu... Read more
GENERAL SURGERY:
Colostomy, Mucofistula May Spell Extra Reimbursement
Look for language specifying how the surgeon attached colonWhen is a partial colectomy not... Read more
You May Not Have To Cope With DME Competitive Bidding
The complicated system of competitive acquisition for durable medical equipment shouldn't ... Read more
EVALUATION & MANAGEMENT:
Learn The Exceptions To History Documentation Requirements
Master the 'ED caveat' to save your physician's reimbursementThose who can't obtain a hist... Read more
HEARINGS:
Congress May Rescue Cancer Payments From Next Year's Shortfall
CMS called on the carpet for IVIG, oncology access problemsOncologists, the House Ways &am... Read more
RADIOLOGY:
Don't Make A Mess Of Stent Placement Coding
Count on vessels to determine the correct number of unitsIf you're reporting multiple sten... Read more
PULMONOLOGY:
Reader Question--Click Your Way To Updates On Bronchodilation--And More
Use Medicare carriers' Web sites to keep you on top of code rule changesQuestion: I have a... Read more
PATHOLOGY:
Ward Off Denials Be Properly Coding A1C Monitoring
You can bill for more than 4 tests a year if the diagnosis warrantsWatch out: If you bill ... Read more
OPTOMETRY:
You Be The Coder--See Clearly When It Comes To Billing For Fundus Photographs
Hint:  Don't let a lack of supporting documentation cloud your chances for reimbursem... Read more
PODIATRY:
Top Tips To Avoid Common DME Denials For Cam Walkers
Keep a watchful eye for certain line item requirementsCam walker reimbursement is a tricky... Read more
OTOLARYNGOLOGY:
Clear Up Mole Removal Coding Confusion
The key to the code lies in the lesion's locationYou won't find a code for "mole removal,"... Read more
CARDIOLOGY:
Make The Grade With New Welcome ECG G Codes
Perform traditional procedures, but don't code them that wayYou know that patients who are... Read more
Part B Coding Coach:
Don't Miss Out On Extended-Hours Payments
Your point of service determines which 2006 CPT codes are right for youWhen you offer serv... Read more
Clip and Save:
Keep 2006 CPT Extended-Hours Code Changes At Your Fingertips
Use our handy chart to find the right code change in a flashSpecial service codes won't be... Read more
PHYSICIAN NOTES:
Plastic Surgeon Should Keep Hands Off Patients' Credit Cards, Court Rules
$4,000 extra charge leads to more than $65,000 in damages-Balance billing- led to a plasti... Read more
EVALUATION & MANAGEMENT:
Beware--Gain To E/M Codes Means Loss To Most Other Codes
Higher-level E/M codes are biggest winnersNot all evaluation & management codes will s... Read more
ONCOLOGY:
Make Your Voice Heard Now To Prevent Steep Drug Cuts
Oncology drugs overpriced by as much as 185 percentFive commonly billed oncology drugs are... Read more
Specialties That Will Be Hit Hardest With RVU Changes
According to the Centers for Medicare & Medicaid Services, a number of specialties wil... Read more
CARDIOLOGY:
You May Have To Close Your In-Office Cath Labs Or Scanning Centers
RVU changes could mean $200,000 pay cut per cardiologistCardiologists face just a 4-percen... Read more
SURGERY:
Surgeons To Reap Benefits Of 5-Year Work RVU Review
Fracture care, lung surgery, digestive surgery codes will growSome specialties gained more... Read more
Say Goodbye To Your Part B Carrier In Six States Next Year
The first combined Part A/Part B Medicare contractor will take effect in July 2007, coveri... Read more
WORKING RVUS:
Prepare For 2007 Cuts With This Work RVU Hit List
Skin debridement, hip arthroplasty may be money losers next yearGet set for steep cuts nex... Read more
Part B Coding Coach:
Don't Get Burned By Critical Care Coding Errors
Hint:  A stay in ICU doesn't always justify a critical care codeThere's more to deter... Read more
Clip and Save:
Find The Right Critical Care Time Code In A Flash
Use the physician's documented time to determine the total unitsFor critical care time las... Read more
PHYSICIAN NOTES:
You Could Have An Easier Time Billing For Off-Label Cancer Drug Uses Soon
Fill out 855 forms online to save time in futureCongress should expand national coverage f... Read more
EMERGENCY MEDICINE:
Prepare For Imminent Audits Of Your ED Visits
Double-check:  Does your E/M documentation support levels? Your Emergency Depart... Read more
REIMBURSEMENT:
Work RVUs For Level-3 Office Visits Set For 37-Percent Hike
Everything changes starting next January. Will you be ready? Good news: Your pay... Read more
GENERAL SURGERY:
Don't Lose Out On Reimbursement For RNFA Services
Smart strategy:  Master surgical assistant modifiersDo you know how to bill for regis... Read more
CONSULTS:
Report And Request Aren't Enough For Consults Without Medical Necessity
Use of modifier 25 exposes that doctor knew he flouted the rulesIf you're worried about ru... Read more
REIMBURSEMENT:
13 Coding Opportunities You May Have Overlooked
You could be turning away your rightful reimbursement for 100s of services Medicare c... Read more
MedPAC Wants To Hold Your Feet To The Fire For Quality
You'll be "held accountable" for the quality of care you provide--if the influential Medic... Read more
ANESTHESIA:
Clear Up These 3 Anesthesia Blind Spots
Not all thoracotomies are created equalAnesthesiology coders, don't sleep on opportunities... Read more
Physician Pay Dropped Since 1995
You may not be surprised to learn that physicians are making less money than they were 10 ... Read more
UROLOGY:
Simplify Your Coding Tasks With New ICD-9 Urinary Symptom Codes
Specificity increases your chances of reimbursement for some E/M services You’l... Read more
GASTROENTEROLOGY:
You Be The Coder--Code Gastrostomy Tube Placements The Right Way Every Time
Scenario: Your surgeon performed a laparoscopic gastrostomy tube placement and laparoscopi... Read more
PATHOLOGY:
Learn To Use Compatibility Blood Tests Only When Needed
Also: Be sure to charge for each unit of blood, but not for each transfusionThere's a new ... Read more
AUDIOLOGY:
Don't Confuse Your SOP Codes--The One You Use Depends On Your Carrier
Helpful hint:  Medicare will reimburse you if your audiologist prepares properly ... Read more
ED CODING:
Choose the Right Service Level Code for Subsequent Hospital Care
To claim 99231-99233, you must meet 2 of the 3 key E/M components Your ED physician ma... Read more
CARDIOLOGY:
3 Must-Know Tips To Ensure Payment For 37215 And 36216
Attach modifier 59 only when catheter placement procedures are distinctThe Office of Inspe... Read more
Part B Coding Coach:
Learn The Secret to Coding Female Urinary Incontinence Surgical Procedures
Hint:  Your physician's approach falls into one of three categoriesThe causes of fema... Read more
Understanding Female Urinary Incontinence
Urinary incontinence is identified as one of four common types: stress (625.6), urge (788.... Read more
Clip and Save:
The Diagnosis Points the Way to the Perfect Incontinence Surgery Code
When your physician documents female urinary incontinence treatment, you have a choice of ... Read more
PHYSICIAN NOTES:
CMS Comes To Your Rescue On IVIG Payments
One code will increase 12 percent next yearYour payments for Part B drugs won't change muc... Read more
NEUROSURGERY:
Reader Questions--Multiple Lesions Can Equal 61793 Times Five
Question: If our neurosurgeon performs stereotactic radiosurgery, is it true that he can... Read more
RADIOLOGY:
Why You May Get Paid For More Chest Radiograph CADs
You could have more chances to bill 0152T soonYou may be able to bill for chest radiograph... Read more
NEW PATIENT VISITS:
Same Group, Different Specialty--How To Collect What You Deserve
Stand your ground when your carrier shoots you down on new-patient visitsWatch out: It's t... Read more
ONCOLOGY:
What's In Store For New Venous Access Device Blood Draw Codes
Don't bill 36415 when your physician does a PICC line blood draw You can look for... Read more
ED Visits May See Upcoding Emergency Soon
Emergency department (ED) physicians and hospitals may be upcoding evaluation & manage... Read more
HOSPICE CARE:
Master Four Modifiers To Ensure Payment For Hospice Patients
Go to the hospice for payment as a last resortBilling for hospice patients can seem frustr... Read more
CPT 2007:
Implantable Ventricular Assist Devices Could Soon Be Payable
You may be able to report S&I with dye injection soon You could have new guidanc... Read more
Part B Coding Coach:
4 Examples Show You The Way To Top-Notch Interferon Coding
Note: You can't bill for drug administration when the patient supplies the drug ... Read more
Watch Out For Hep C Symptoms That Can Trip Up Your Coding
When you receive documentation for a patient that has hepatitis C, there are some signs an... Read more
PHYSICIAN NOTES:
Don't Expect Any Action On Medicare Cuts Until Year's End
Abbreviations may shorten the lives of your patientsA desire to prevent a cut to your paym... Read more
REIMBURSEMENT:
Are You Missing Out On Pre-Op Consults Or Time-Based Coding?
Don't be afraid to bill for your rightful reimbursementAre you a chronic undercoder? The t... Read more
REIMBURSEMENT:
Make Sure You're Billing The Correct Codes
Don't miss out on splenic flexure, lesion repair Important: Don’t assume a ... Read more
ORTHOPEDICS:
New Edit Could Cost You $1,500 Per Surgery
Spine surgeons stiffen their backbones in opposition to bundle Watch out: A new Corre... Read more
CAP Deadline Extended
If you've been mulling over joining the Competitive Acquisition Program for Part B drugs, ... Read more
CCI EDITS:
You Can't Use A Modifier To Override New Cholecystectomy Edits
Hospital day discharge management and critical care now billable together If your fac... Read more
Doctor, Nurses Both May Have Liability For Infusion SNAFU
A court must consider whether Ohio physician Josef Korinek was negligent, the Court of App... Read more
DIAGNOSIS CODING:
Educate Your Physician To Record More Details On Epilepsy
New ICD-9 codes offer more specificity on HCKD, prostate disease and SIRS You can get... Read more
ORTHOPEDIC:
Increase Your Pilon Fracture Coding Know-How With This Advice
Helpful hint: You will report 27828 most often Don’t be fooled into thinki... Read more
UROLOGY:
Nail Down Rules For New And Established Patients
Learn how the 3-year guideline determines what you will report The timeframe in which... Read more
ONCOLOGY:
2 Examples Help You Master Melanoma Consult Coding
Bad news:  Using a nonphysician practitioner could cut reimbursement by 15 percentCar... Read more
RADIOLOGY:
Know The Difference Between 'Complete' And 'Incomplete' For Duplex Scans
Get the lowdown on when 93975 and 93976 are applicableIf you receive notes from your radio... Read more
GASTROENTEROLOGY:
Reader Question--Settle On Signs And Symptoms When You Lack Clear Documentation
Question: Oftentimes, we receive documentation from our gastroenterologist that doesn't in... Read more
PODIATRY:
Ease Your Corn And Callus Confusion With These Pointers
Rely on codes from the 700.x series to keep your claims steady Corns and calluses are... Read more
Part B Coding Coach:
Capture Cardiac Monitoring Blunders Before It's Too Late
Important:  Only report the services the physician providesGetting cardiac monitoring... Read more
PHYSICIAN NOTES:
Doctor May Have Violated Killer's Confidentiality
1 in 5 doctors now has access to full-fledged information technologyNorth Dakota physician... Read more
E&M CODING:
Make Sure Organs Are Absent And Accounted For In E/M Scoring
Warning:  Just a mention in the history isn't enoughDon't count out absent organs whe... Read more
REIMBURSEMENT:
Stay Tuned For Rule Revolutionizing RVUs
Include the 'KX' modifier on every line of your PT claimsYou could get a glimpse of the fu... Read more
90772 Problems Solved
Carriers may have finally cleaned up their act when it comes to accepting drug administrat... Read more
GASTROENTEROLOGY:
Follow Your Carrier Policies On Screening Exams That Find Trouble
CMS officials start backtracking on February clarification If you thought your doubt ... Read more
AMA Comes Down On Managed Care Plans
The big health plans are getting bigger and smaller plans are going away--and you could ... Read more
COMPLIANCE:
Alternatives To Signatures May Be Legal-But Are They Payable?
Research your state's laws before you look into stamps or e-signaturesYour doctor's gettin... Read more
Prosecutors Couldn't Swallow Nursing-Home Tests
Radiologist Robert Riether and his wife Judith could face a stiff prison sentence for fr... Read more
MEETINGS:
CMS Doesn't Feel Your Part D Pain
Nurse practitioners soon may be able to bill for their own services in hospitals The ... Read more
Part B Coding Coach:
Take The Guesswork Out Of Ventilation Management Coding
3 helpful hints show you how to get the reimbursement you deserveSelecting the proper vent... Read more
PHYSICIAN NOTES:
Doctors With Abundant Resources At Their Fingertips Less Happy Than Others
Survey proves once and for all that money can't buy happinessDoctors in areas with more me... Read more
RECOVERY AUDIT CONTRACTIONS:
Keep An Eye On The Charts Requested by 'Bounty Hunters'
If the RACs recycle your appealed claims, contact CMSThe Recovery Audit Contractors, ... Read more
MODIFIERS:
Prepare Now For Modifier 25 Crackdown
Make sure your documentation is in order before billing separate E/M services If you... Read more
ENROLLMENT:
Deadline To Obtain NPIs For New Doctors Is Coming Up
Warning: Carriers won't give you any leeway on enrollment jamIf you don't have nation... Read more
Intestine Transplant Facilities Still Must Have 10 Surgeries Per Year
CMS won't change its current rule for approving intestinal transplant facilities, the agen... Read more
MEDICALLY UNBELIEVABLE EDITS:
Believe It Or Not,You May Be Able To Bill For Unlikely Services
Watch out for MUE proposal in AugustGood news: You may not have another smothering layer o... Read more
3 CMS Sites Provide Info On Medicare Services, Plus Training Opps
If you're still trying to decide whether to enroll in the Competitive Acquisition Program ... Read more
TRANSMITTALS:
Speak Up To Keep Bad Local Policies From Spreading
Stop using the obsolete QV modifier for PET scansIf you like your carrier's Local Coverage... Read more
Moratorium On Physician Ownership Of Specialty Hospitals Sunsets
Medicare could lead a new crackdown on your doctor's investments in specialty hospitals (w... Read more
ORTHOPEDIC:
Avoid Allograft Coding Conundrums With This Advice
Tip: Only report CPT Codes 20931 once per surgery If you’re still scratchi... Read more
UROLOGY:
4 Examples Break Down Coding For Bladder Tumor Removal
Learn why tumor size can make all the difference You could land in coding hot water i... Read more
PODIATRY:
Walk A Straight Line To Accurate PT Reimbursement
You are allowed to report 97001-97546You can receive payment when you perform physical the... Read more
OPHTHALMOLOGY:
Keep Your Eyes Peeled For Covered Cornea Remodeling Services
AK fixes can earn your practice money--if Medicare deems them medically necessary Cor... Read more
INTERNAL MEDICINE:
Earn Extra Dollars For Certain Hearing Services
Here’s how one procedure could put $50 in your pocket Don’t miss out on r... Read more
GENERAL SURGERY:
Cut To The Mesh Placement Chase With These Clues
New change:  49658 is now bundled into all hernia repairs If you think that you ... Read more
Part B Coding Coach:
3 Tips To Tackle Your TIPS Coding Woes
Important:  Avoid costly ICD-9 mistakes and differentiate between insertion and rev... Read more
Solve The TIPS Medically-Necessary Dilemma At Last
Before you code for transvenous intrahepatic portosystemic shunt (TIPS), you must know whe... Read more
PHYSICIAN NOTES:
Physician Kickbacks Lead To Record Payout
Doctor prescribed Oxycontin to random patients, gets 150 months If you didn’t t... Read more
NEUROLOGY:
Reader Question--Say Farewell To G0355 For Avonex Administration
Question: Last year, a number of carriers--but not all--changed their coding preferences... Read more
COVERAGE:
Are You Ready For The Bariatric Surgery Coverage Checklist?
Only certified facilities will meet coverage criteriaYour surgeon can obtain Medicare reim... Read more
PHYSICAL THERAPY:
PT Not OK, Warns OIG
Medicare spends $136 million on improper claimsYour physical therapy claims could be a leg... Read more
Malpractice Reform Bills Die On The Operating Table
Senate Democrats put an end to physicians' hopes of malpractice reform when two competing ... Read more
CONSULTS:
Can You Still Bill A Consult If You Treat The Problem?
Make sure you have the written request in your filesMost consults are medically necessary-... Read more
DIAGNOSIS CODING:
5 Steps Take the Heat Out of Burn Diagnoses
Make sure you know the questions to ask to choose the proper codeWatch out: Don't get burn... Read more
COMPLIANCE:
Don't Bill Incident-To Unless Your Doctor Is Involved
Practices sail into 'gray area' of incident-to billingWatch out: If your practice is consi... Read more
Part B Coding Coach:
Halt Your Hip Coding Headaches With These Helpful Hints
Stay away from 26992 or face denialsIf you think you should report V54.81 for a hip replac... Read more
PHYSICIAN NOTES:
The End Of September Could Be Your Cash-Flow Downfall
Medicare will freeze your payments this fallBrace yourself for nine lean days in late Sept... Read more
CONSULTS:
Consult Confusion Just Got More Tangled
You don't have to verify documentation, but it should be thereYou've been tearing out your... Read more
COPAYMENTS:
Don't Write Off Low-Income Copays Until You Get The Facts
Good news:  Your state may cover copays, even for non-medicaid patientsIf your practi... Read more
WOUND CARE:
Reap The Rewards For VAC Wound Care Now
Physicians can bill for 97605-97606 Cutting-edge wound care technology will now receive th... Read more
Doctor Can Never Use That Title Again, Judge Orders
A defrauder of Medicare gets stripped of her freedom, her medical license--and her title.A... Read more
INCIDENT-TO BILLING:
Pre-2002 Incident-To Claims Could Still Wind Up In Court
Now is the time to scrutinize your documentationIgnorance of the incident-to law is no exc... Read more
PART B DRUGS:
OIG To CMS--51 Drugs May Be Overpriced
Watchdog wants tougher method for calculating ASPsA few dozen Part B drugs could be facing... Read more
Is CMS Just Going Through The CAP Motions?
The Centers for Medicare & Medicaid Services finally issued instructions on how to enr... Read more
RADIOLOGY:
Find Arthrography And Epidurography Coding Success With These Clues
Why accurate documentation could earn you an extra $40You have a few coding choices when y... Read more
ANESTHESIA & PAIN MANAGEMENT:
Reader Question
Lean On Long-Term Use Codes For Monitored Anesthesia CareQuestion: If a patient takes high... Read more
PODIATRY:
Rest Easy With Updated Rest Home Coding Requirements
Use 99201 to report low-level new patient visitsIf you're still using 99331-99333 to code ... Read more
GASTROENTEROLOGY:
2 Examples Show You How To Get Ahead Of The GERD Testing Game
Tip:  A standard pH test only requires one codeYou can ease many of your coding heada... Read more
NEUROLOGY:
Don't Let Lack Of Seizure Diagnosis Codes Stop You In Your Tracks
Strategy:  Adding a fifth digit could provide the needed specificityProblem: The ICD-... Read more
ORAL & MAXILLOFACIAL:
Hitch On To These Hardware Removal How-Tos
Find out which CPT code could put $491 in your pocketYou know that when you bill for hardw... Read more
Part B Coding Coach:
Steer Clear Of Post-Op Modifier Mix-Ups With These 3 Clues
Discover denial-proof uses for 78, 79 and 80Post-operative procedure claims often require ... Read more
Test Your Modifier Knowledge With This Quick Quiz
You've just read about how to properly apply modifiers 78, 79 and 80. Now put what you've ... Read more
PHYSICIAN NOTES:
Commission Dropped Charges, But Didn't Clear Doctor's Name
You can't sue to keep your name out of federal data bankA physician who passed through the... Read more
DRUGS:
If You Rely On CAP Vendor For Drugs, You'll Have No Backup Source
This CAP only has one featherThe Competitive Acquisition Program (CAP) for Part B drugs lo... Read more
COMPLIANCE:
Come Clean, Or We'll Fight Dirty, OIG Warns
Your deals with hospitals could be under the lens soonThe HHS Office of Inspector General ... Read more
MODIFIERS:
Learn The Cure For 52/53 Modifier Headaches
Document the reason for a discontinued or reduced procedureAn incomplete procedure doesn't... Read more
AUDITS:
Don't Bill A High-Level E/M Claim Until You Read This
Protect yourself from carrier audits with these handy tipsWatch out: Carriers are looking ... Read more
Now's Your Chance To Comment On MAC Transition
Soon your Part B carriers will be a thing of the past. The Centers for Medicare & Medi... Read more
IMAGING:
Your Imaging Reimbursement Could Be In For A Third Hit Soon
Neighboring physicians see 10-percent payment differenceYour practice expenses for MRIs an... Read more
Part B Coding Coach:
Clear Up Cessation Counseling Claims With These Clues
Find out when it's appropriate to attach modifier 25Tobacco-use counseling can benefit smo... Read more
Learn How Your Facility Must Pay Up
  Reimbursement for cessation counseling may depend on the type of facility that per... Read more
PHYSICIAN NOTES:
Medicare Will Cover Pancreas Transplants--But Only In a Few Cases
Doctor who underdosed cancer patients gets a full dose of prisonYour physician can soon st... Read more
ICD-9 CODES:
New Torsion, Mental Status Codes May Help You Reap Reimbursement
Start mastering the new ICD-9 Codes now With new ICD-9 codes on the horizon, your pro... Read more
DENTAL SERVICES:
2 Practices Succeed In Overturning 'Routine' Dental Denials
Medicare will cover dental services when they're medically relatedDon't take a denial of "... Read more
AUDITS:
Every Minute Counts When You Respond To Prepayment Audits
Start a dialogue with your carrier, and get your physician involvedWhen it comes to dealin... Read more
AUDITS:
Get To The Bottom Of Audits--And Come Out On Top
Download carrier scoresheets from the WebWhy do bad audits happen to good coders?Asking wh... Read more
Democrats Trying To Overturn Deficit Reduction Act
Congressional representatives are now hopping on the bandwagon to defeat the Deficit Reduc... Read more
EMERGENCY CARE:
Coding For Suture Depends On The Future
Use 54 modifier if ED physician doesn't plan to remove suturesQuestion: A patient comes in... Read more
Understand The National Coverage Process
CMS is offering more clarity on how it decides which local coverage determinations (LCDs) ... Read more
OPHTHALMOLOGY:
Opt For Modifier GY For Never-Covered Services
Helpful hint:  No ABN necessaryWhen your ophthalmologist performs a service that Medi... Read more
PATHOLOGY:
Find FOBT Coding Success From 82270 To 82274
Double-check method--and specimen Billing rules for fecal occult blood test (FOBT) ha... Read more
NEUROLOGY:
Say Goodbye To 436 And Hello To 434.9x For Stroke
Bonus:  New code will allow for reimbursement on some noncovered servicesIf you've be... Read more
FAMILY PRACTICE:
Ensure Payment For Diabetes Counseling By Verifying Frequency Allowances
Also:  If you don't include a diabetes diagnosis on your claim, expect a denialScenar... Read more
GENERAL SURGERY:
Turn To Modifier 24 For Post-Op Evaluations
Caution:  Only use it when complications arise You do have the option to report ... Read more
ONCOLOGY:
Reader Question--Minutes Make The Difference For Colorectal Cancer Coding
Question: I have documentation for a patient with metastatic colorectal cancer (primary ne... Read more
Part B Coding Coach:
Tackle TENS Unit Coding With These
Learn why the correct codes are key to proper reimbursement.Coding for transcutaneous elec... Read more
PHYSICIAN NOTES:
Secrets Of E/M Documentation Are On The CMS Site
Learn the ABC's of AV fistulasNeed a refresher course in evaluation and management (E/M) d... Read more
ORTHOPEDIC:
Reader Question--Don't Forget ICD-9 Code When You Report Finger Amputation
Question: We have documentation for a 37-year-old male patient who accidentally injured ... Read more
REIMBURSEMENT:
Get Ready--Your Payments Could Be Slashed To The Bone Next Year
CMS estimates a 4.6 percent cut awaits you in 2007And so it begins again. The Centers For ... Read more
POWER OPERATED VEHICLES:
Teach Your Physician To Document Wheelchair Medical Necessity
Hint:  G0372 must be on the same claim as E/M codeDon't miss out on an extra $21.60 o... Read more
MODIFIERS:
Don't Let Modifier Confusion Keep You From Getting Paid
6 tips for keeping track of which modifiers your non-Medicare payors want If every pa... Read more
Will 2007 Budget Include Medicare Cuts?
House lawmakers broke for a two-week Easter recess without voting on a fiscal year 2007 bu... Read more
PRIVACY:
Watch out-- Patient E-mails Could Be Your Privacy Weak Spot
Treat your patient's health e-mails like other medical records You work like craz... Read more
ICD-9 CODES:
Start Learning 2007 ICD-9 Codes Now
Compartment syndrome, drug allergies covered by new codesYou can stop using "unspecified" ... Read more
Part B Coding Coach:
Stay Out Of Hypertension Coding Hot Water
Key:  Learn the difference between malignant, benign and unspecifiedWhen coding for h... Read more
PHYSICIAN NOTES:
Don't Get Lost In The NPI Transfer Shuffle
Doctors can't be sued for emergency care to other doctors' patientsWhen you apply for a na... Read more
TESTING:
Know The Difference Between G0107 And 82272--Or Lose Money
Medicare won't cover 82270 for diagnostic testing anymoreIf you're still using the same co... Read more
CONSULTS:
Don't Let Poor Documentation Thwart Your Consult Reimbursement
5 timely tips will help you avoid consult paybacksThe feds are coming to look into your co... Read more
Sample Letter For Confirmation Of Consultations
Dear Dr. ______________,It is our understanding that you have requested Dr. ______________... Read more
CONSULTS:
Create Your Own Decision-Making Chart For Consults
Pay attention to ROS and exam, or your level 5 could turn into a level 3Watch out: If your... Read more
PAY FOR PERFORMANCE:
Give P4P A Test Run--With No Pay At Stake, Suggests CMS
Start now, and you'll receive a confidential report by DecemberMedicare's Physician Volunt... Read more
Four New Category II Codes For PVRP
The American Medical Association has come up with Category II codes that Medicare can acce... Read more
PATHOLOGY:
Keep Alert--No Pathologist, No Pay For Array Testing Codes
New molecular probe codes sow confusion among providersIf you don't have a pathologist sup... Read more
PODIATRY:
Ward Off Wound Care Coding Denials With 15340
Learn which common podiatry products line up with new skin graft codes Hot on the hee... Read more
OB-GYN:
Discover How V Codes Signify Patient's History
Helpful hint: List disease signs and symptoms firstPersonal and family history V code... Read more
GASTROENTEROLOGY:
Using 46221 To Report Hemorrhoid Removal? Not So Fast
Suture ligations may require another code--depending on the circumstancesHemorrhoid locati... Read more
UROLOGY:
Sharpen Your Vasectomy Coding Skills With This Guidance
Find out when it's appropriate to add 80 or 82 modifiers to the mixOne code describes all ... Read more
RADIOLOGY:
Reader Question--Ace Abdominal Aortic Aneurysm Coding
Question: I am having trouble coding percutaneous abdominal aortic aneurysm (AAA). Could y... Read more
NEUROSURGERY:
2 Scenarios Show Effective B Code Use For Neurosurgery Aftercare
Explore your options to indicate follow-up examsDon't be surprised when you see a V code l... Read more
OTOLARYNGOLOGY:
Reader Question--Pinpoint Exam Area--Not Insertion Location--For Proper ENT Coding
Question: I'm trying to understand how to distinguish between nasopharyngoscopy and laryng... Read more
Part B Coding Coach:
Confused About Coding Diabetic Manifestations? 4 Tips Show You How
First step:  Check the physician's documentation for diagnosis cause Remembe... Read more
Beware:
Avoid These Diabetes Coding Pitfalls
When coding for diabetes, if you're listing the manifestation first, you're making a mista... Read more
PHYSICIAN NOTES:
Stent Placement, Gastric Bypass No Longer Covered
Medicare Advantage plans win 4-percent pay hike next yearMedicare will no longer pay for t... Read more
RADIOLOGY:
Learn How To Bill For Pelvic And Transvaginal Ultrasounds On Same Day
Carriers seek documentation that supports both exams on same dateYour carrier may not be u... Read more
INJECTIONS:
Watch Out--Carriers Deny E/M Service With 90772
Don't forget the 25 modifier, but separate diagnosis isn't necessaryMedicare is supposed t... Read more
Don't Let A DME Supplier Rent Your Closet
A proposed deal in which a durable medical equipment supplier would provide DME to a physi... Read more
DIAGNOSIS CODING:
Keep Track Of Diagnoses That Change During Hospital Stays
Educate  your physician to keep you in the loop on patients' developmentJust because ... Read more
Feds May Look Into Podiatrists' Nail Debridement Claims
Medicare could save $285 million per year if it cracked down on chiropractors billing for ... Read more
CARDIOLOGY:
Are You Billing The Wrong Code For Heart CTAs?
Hint: Get heart CTA claims off your chestCoders are clinging to CPT code 71275 for he... Read more
Don't Let Hospital Talk To Insurers For You
A group of 192 physicians could get more than they bargained for if they go ahead with a p... Read more
CONSULTATIONS:
Prepare For A New Crackdown On Consult Billing
Three out of four consults billed incorrectly, OIG says Now’s the time to revie... Read more
Part B Coding Coach:
Learn 4 Tricks To Code Your Physician's Prolonged Services Correctly
Hint:  Face-to-face time in an outpatient setting does not have to be continuous ... Read more
PHYSICIAN NOTES:
Electronic Health Records Could Get Boost From Federal Employees
Bill would require EHRs and performance-based funding for fedsYou could be seeing wider us... Read more
RADIOLOGY:
Alert-- Double Whammy Next Year Will Slash Your Imaging Reimbursement
Some imaging codes will lose up to 70 percent of technical componentA total of 150 radiolo... Read more
CARDIOLOGY:
Don't Let Two Catheterizations On The Same Day Confound You
Hint:  You can't have a diagnostic cath twice at different facilities When o... Read more
CODING UPDATES:
It's Up To You To Resubmit Spine Surgery Claims
Carotid artery stenting no longer payable with 37216Who says the Centers for Medicare &... Read more
Know Your Imaging Costs Now, Or Pay The Price Next Year
With the technical component for some imaging scans dropping by double-digit amounts (see ... Read more
DIAGNOSES CODING:
Symptoms But No Diagnosis--How Do You Bill Tests?
Know the difference between covered and non-covered symptomsSometimes your doctor orders d... Read more
Medicare Uses 'Swiss Cheese' To Protect Patients' Information
Medicare is collecting information on millions of Americans and failing to keep it secure,... Read more
CARDIOLOGY:
Cardiology Practices Gain A Leg Up In Diagnosing ICD Patients
But Medicare won't expand coverage for ECP after allSoon you'll be able to bill for a valu... Read more
INTERNAL MEDICINE:
2 Examples Help You Ace 'Incident-To' Rules For NPs
Refresher:  The key to 100% payment lies in an established plan of careYou know Medic... Read more
NEUROSURGERY:
Reader Question--Cut Out Modifiers When You Code For Vertebroplasty
Question: We have documentation that the neurosurgeon performed vertebroplasty at more tha... Read more
ONCOLOGY:
Settle On 285.22 For Accurate Anemia Coding
Find out why you must pay attention to the chronic conditionNew anemia coding guidelines h... Read more
DERMATOLOGY:
Clear Up AK Coding Confusion With These Clues
Bonus:  You may be able to reap nearly $200 in reimbursementActinic keratoses (AK) ar... Read more
CARDIOLOGY:
Reader Question--Learn Why Catheter Coding Boils Down To Crossing The Heart
Question: We have documentation from the cardiologist's op report that states he performed... Read more
Part B Coding Coach:
Dust Off Category II & III Codes And Put Them To Use
We'll help you unveil the mystery of the back of your coding book. Don’t ig... Read more
PHYSICIAN NOTES:
CMS Will Allow Second Round Of MUE Comments
'Medically unbelievable' edits shouldn't cramp your style You may be able... Read more
OPHTHALMOLOGY:
Reader Question--Prepare Cataract Patients To Bear Cost When Requesting PC-IOL
Question: After cataract surgery, an ophthalmologist inserts a Crystalens intraocular le... Read more
EMERGENCY MEDICINE:
You Thought Moderate Sedation Was Hard To Bill For, Wait Till April
You can't bill for E/M codes separately unless you can justify a modifierSo far, no Medica... Read more
EDITS:
New Medicare Edits Go Beyond CMS Mission
Watch out for another layer of edits, coming soonThe Centers for Medicare & Medicaid S... Read more
Hemorrhoid Treatment Codes Hit With Unbeatable Edits
Ten digestive surgery codes become components of hemorrhoidopexy code 46947 starting April... Read more
GENERAL SURGERY:
You Can't Use A Modifier To Override Wound Care Edits
Anesthesia not separately payable with wound therapy, CMS saysIf you're using cutting-edge... Read more
Ureterectomy Bundled Into Over 100 Codes Without Recourse
A modifier won't help you override edits that make CPT code 50650 (Uretorectomy, with blad... Read more
ELECTRONIC HEALTH RECORDS:
Beware The Attack Of The Cloned Documentation
Most EHR systems don't let you track who made changesThe most common electronic health rec... Read more
RADIOLOGY:
Radiology Coding Just Got More Complicated
April brings a lot more than showers this year--next month will also shower radiologists w... Read more
Part B Coding Coach:
4 Winning Tips Help You Update Your Turbinate Surgery Coding
Get familiar with the "unlisted" code for middle turbinate proceduresOtolaryngology coders... Read more
PHYSICIAN NOTES:
Medicare Needs More Up-To-Date Data On Your Practice Expenses
CMS should consider scrapping '50 percent' rule, commissioners sayThe Centers for Medicare... Read more
AUDITS:
Now Medicare 'Bounty Hunters' Will Receive Payment For Rescuing Yours
P4P train 'has left the station,' CMS saysIf you thought you were safe from the Recovery A... Read more
GYNECOLOGIC ONCOLOGY:
Resubmit Denied Demonstration Claims To Gain Extra Payment
CMS backtracks on oncology demonstration projectGood news: Gynecologic oncologists will be... Read more
EVALUATION & MANAGEMENT:
Make Your Phone A 'Hot Line' For E/M Reimbursement
Carrier says physicians' phone time can bump up E/M levelsDoes your physician spend precio... Read more
Quality Organizations Have Their Own Quality Problems
Who watches the watchers? That's what Sen. Chuck Grassley (R-IA) wants to know.The influen... Read more
STUDIES & SURVEYS:
Massive Decreases In Drug Payments May Be Coming Your Way
Medicare overpaid $110 million for Part B drugs in 2005, says OIGIt may be hard to believe... Read more
NPI Applications Made Simple
The Centers for Medicare & Medicaid Services recently posted new information to help p... Read more
COMPLIANCE:
Don't Play The Percentages With Overdue Copays And Deductibles
Watch out for state, federal laws on charging patients interest and surchargesPatients who... Read more
UROLOGY:
Reader Question--Turn To 2 Codes For Repeat TURPs
Question: Our urologist recently saw a patient who had a prostatic fossa with regrown pros... Read more
AUDIOLOGY:
Reap Auditory Rehab Code Benefits
Find out how you can receive an extra $22A few months have passed and you should now be fa... Read more
PODIATRY:
Keep Your Gait Analysis Claims Steady
Helpful hint:  Double-check your Medicare carrier's coverage guidelines for each.If y... Read more
RADIOLOGY:
Don't Let Multiple Radiation Treatments Trip You Up
Experts warn:  Make sure documentation proves medical necessityCertain types of cance... Read more
NEUROLOGY:
Don't Be Unnerved By Unbundled Claims
If you perform tests on the same nerve, report the more extensive codeWhen your neurologis... Read more
ORTHOPEDIC:
See Your Way Through CMC Anthroplasty Transplant Coding
If you only use 25447, expect to lose big bucks When deciding which CPT Codes to repo... Read more
Part B Coding Coach:
Don't Let Suture Removal Coding Get You In a Stitch
See why using a 52 modifier on 15850 and 15851 is not a valid optionReporting suture remov... Read more
PHYSICIAN NOTES:
Emergency Room Physicians Can Charge Patients A 'Reasonable' Fee
Court rules that 'balance billing' isn't illegal in the ER It's not illegal for emergency ... Read more
ORTHOPEDIC:
See Your Way Through CMC Anthroplasty Transplant Coding
If you only use 25447, expect to lose big bucksWhen deciding which codes to report for CMC... Read more
PHYSICAL MEDICINE:
Reader Question--Learn The ABCs of ADL Coding
Question: We have documentation for three patients, all knee amputees, who were recently... Read more
ICD-9 CODES:
Prepare Now For Secondary Diabetes Codes
10 diagnoses could obtain new ICD-9 codes in October The next batch of ICD-9 diagnosi... Read more
REIMBURSEMENT:
AMA Defends Quality Improvement Deal With Congress
Association didn't give away the store on P4P, it insistsYour specialty associations react... Read more
COMPLIANCE:
Flat Fees, Fair-Market Payments Won't Get You In Hot Water
Learn to navigate 4 tricky Stark law exceptionsNobody ever accused the Stark law of stark ... Read more
Party of Five Won't Trigger Stark Law
Good news: You can reward a group of physicians within your practice for using a lot of an... Read more
THERAPY:
Overcome Therapy Caps With New Exceptions Process
What you don't know could cost your Part B therapy business $1,000sThe new Medicare reimbu... Read more
CRITICAL CARE:
Post-Op Health Crisis? You Can Bill Separately For Critical Care
Pay attention to diagnosis codes, time-based documentationYou may think you should write o... Read more
Part B Coding Coach:
Nail the New Consultation Rules With These Real-World Examples
Warning: Don't let your newfound in-group consult option get out of hand You... Read more
PHYSICIAN NOTES:
Primary Care Doctors Face Total Breakdown Unless Payments Rise
Commission proposes reforms in RVU setting methodsCongress should give you a 2.8 percent p... Read more
EMERGENCY MEDICINE:
Bill New Moderate Sedation Codes--Even If They Don't Pay
Medicare is watching your usage of these codesMedicare never paid for conscious sedation i... Read more
CO-MANAGEMENT:
Don't Fall Into An Unpaid Coordination Trap
For coordinating physician, underlying diagnosis may be key to paymentWhen two physicians ... Read more
AUDITS:
Look For Time Bombs In Your Medical Records
8 tips to improving your chart audit successYou could be throwing money away if you're not... Read more
Medicare Reversis Course On Bariatric Surgery
The Centers for Medicare & Medicaid Services will pay for bariatric procedures for sen... Read more
AUDITS:
Can You Spot These 12 Red Flags In Your Charts?
Spot the trouble signs before they turn into disastersWhen you're auditing your charts, wi... Read more
NEUROSURGERY:
You Could Gain An Extra $2,700 For Placing Stereotactic Markers
Use unlisted code for fiducial marker placementIf your neurosurgeon is performing "framele... Read more
NEUROSURGERY:
Reap Rewards When You Report Consultations With 61793
Documentation should indicate both codes--and modifiersIf you're applying the recent NCCI ... Read more
ORTHOPEDIC:
Know Your Spinal Infusion Reimbursement Rights
Key: Append modifier 51 to removal/reinsertion codesIf you think you can't bill instr... Read more
PODIATRY:
Face The Routine Foot Care Music With This Advice
Why fraudulent diagnosis codes landed a podiatrist a 33-month prison sentenceSame-day eval... Read more
GENERAL SURGERY:
Reader Question--Math Is A Must When You Report Wound Repairs
Question: We have documentation indicating a surgeon removed two benign lesions from a pat... Read more
CARDIOLOGY:
Eight Is Enough For Day-Long Observation Or Inpatient Care
Learn when 99234-99236 is appropriate--and when it's notThe timeframe in which a patient r... Read more
OPTOMETRY:
Plug In To These Punctum Plug Reimbursement Rules--Or Pay The Price
Report 68761 using E1-E4When it comes to punctum plugs or punctum closures, keep your eyes... Read more
GASTROENTEROLOGY:
Reader Question--Two Codes Are Better Than One For Control Of Bleeding
Question: I received a claim that shows the gastroenterologist injected epinephrine into a... Read more
Part B Coding Coach:
Learn 4 Coding Secrets For Your Mid-Level Providers' Services
Tip:  All NPPs in your facility should have a Medicare PINDon't let the rules fo... Read more
PHYSICIAN NOTES:
Say Goodbye To Level Four E/M Visits In SW Ohio
One practice loses $430,000 per year thanks to 'blended' visitsYou'd better hope your priv... Read more
REIMBURSEMENT:
RVUs In For Big Changes--Will You Win Or Lose?
Now's the time to speak up about drastic PE-RVU changesSome CPT codes could see double-dig... Read more
APPEALS:
Here's Who To Call To Get Appeals Settled Faster
Some carriers require redeterminations even for minor errorsthanks!The new and improved ap... Read more
DRUG REIMBURSEMENT:
How To Use The Three New 'J' Modifiers In The Drug Vendor Program
CMS will let you use a non-vendor drug in emergenciesFeeling crushed by high drug prices a... Read more
More CAP Details You Need To Know
In Transmittal 839, CMS also explains that:• CAP vendors will be chosen every three... Read more
NEUROLOGY:
Don't Take EDX Denials Lying Down
Submit extra documentation to override AANEM guidelinesMyth: Think your patients can never... Read more
Non-Participating Physicians Should Contact Carriers For Adjustments
The carriers processed Medicare claims at the new 2006 fee schedule level within a few day... Read more
GENERAL SURGERY:
Quick Tips For Screening Colonoscopies That Turn Up Trouble
Include the screening "V" code, but not in the primary positionDon't let confusion over th... Read more
Part B Coding Coach:
6 Shots At Infusion Coding Success In 2006, Part II
New CPT guidelines instruct you to choose one service to report as the "initial&quo... Read more
PHYSICIAN NOTES:
Will Congress Help You Avoid Another Lean January Next Year?
Fixing physician payment mess top priority, Congressman insistsNow that you've finally bee... Read more
EVALUATION & MANAGEMENT:
Don't Hold Your Breath For New National E/M Guidelines
But keep an eye open for more carrier-level meddlingThe American Medical Association shows... Read more
APPEALS:
Claim Denied? Don't Give Up Too Easily
One neurosurgery provider succeeds in convincing payor to cough upJust because Medicare do... Read more
Last Chance To Weigh In On Your Carrier's Performance
If you received the Medicare Contractor Provider Satisfaction Survey (MCPSS) and didn't re... Read more
INJECTIONS:
Will CPT 2007 Include A Code For Non-Supervised Injections?
Use 59 modifier for multiple injections per day When CPT 2006 introduced new injectio... Read more
Physician-Owned Specialty Hospitals Threaten Community Hospitals
Your physician's cardiac, orthopedic or surgical specialty hospital may be chipping away a... Read more
NEUROLOGY:
Don't Miss Out On Extra Units With NCS Codes
8 tips to gain your proper reimbursement for 95900-95904Don't let nerve conduction study (... Read more
Bush Budget Calls For P4P--But No More Money
If you were hoping for a nice juicy carrot to encourage you to go along with pay-for-perfo... Read more
OPTHOPEDICS:
Alert--Now's The Time To Fight For ESWT Coverage
Two carriers already say they won't cover new code 28890 Coders rejoiced when CPT... Read more
OTOLARYNGOLOGY:
Reader Question--Clean Up Your Earwax Coding With These Cues
Question: A patient came into our office and noted earwax removal as her chief compliant. ... Read more
RADIOLOGY:
2 Choices To Chart Your Bovine Arch Coding Course
Uncover the difference between using 2nd- and 3rd-order catheter codesThere isn't one set-... Read more
DERMATOLOGY:
Keep Your Eyes Open For Medically Necessary Eyelid Procedures
Carriers will cover blepharplasty for functional or reconstructive surgeries Medicare... Read more
ANESTHESIA:
Learn Why Your Anesthesiologist's Location Matters
3 Important factors help you understand what signifies "physically and immediately availab... Read more
ORTHOPEDIC:
Say Hello To Specific Prosthesis Complication Codes
996.4 now includes a fifth digitIf you've been using 996.4 (Mechanical complication of int... Read more
Part B Coding Coach:
6 Shots At Infusion Coding Success in 2006
G codes for chemo are gone--and new CPT chemo administration codes aren't just for c... Read more
PHYSICIAN NOTES:
ACP Wants To Turn Your Practice Into A Super-Practice
Congress should provide more money to reward physicians for qualityPrimary care physicians... Read more
PODIATRY:
Reader Question--Start Your Diabetic Shoe Program On The Right Foot
Question: Our office is about to start a diabetic shoe program. What must we do to becom... Read more
RADIOLOGY:
Alert--Medicare Will Cap Imaging Payments At Outpatient PPS Rates
Congress passes 'stealth cut' of physician reimbursementThe bad news just keeps coming for... Read more
UROLOGY:
Don't Miss Out On Guidance Codes, Or You May Lose All Reimbursement
Document ileal conduit to receive your proper reimbursement for tube removalConfused by th... Read more
PREVENTIVE VISITS:
An Ounce Of Prevention Is Worth Billing For
6 tips for billing preventive services along with Medicare-covered services Think you... Read more
PAY-FOR-PERFORMANCE:
Quality Is Still Its Own Reward Under Medicare
Pay-for-performance program is looking a lot less likelyOn Feb. 1, the U.S. House of Repre... Read more
How To Cope With Multiple Imaging Discount
If you perform more than one imaging scan on "contiguous" body parts, you'll have a 25-per... Read more
ORTHOPEDICS:
Combine Orthotic Training Code With Strength Training To Boost Your Pay
You can bill for training on the same day as an orthotic/prosthetic checkoutIf your physic... Read more
Part B Coding Coach:
Polish Your Modifier 59 Knowledge and Master CCI Edits in 5 Steps
The OIG is telling your carriers to crack down on incorrect unbundlingThe National Co... Read more
PHYSICIAN NOTES:
Only The Most Efficient Practices Will Pass New NCQA Standards
Will your office be ready?The National Committee for Quality Assurance (NCQA) today releas... Read more
CORRECTION
Correction: The headline of an article in PBI Vol. 7, No. 20. incorrectly referred to mesh... Read more
CORRECTION
CORRECTION:  The headline of an article in PBI Vol. 7, No. 20. incorrectly referred t... Read more
CONSULTS:
It Takes Two Physicians To Document A Consult Request
Doctors can request consults from others in the same groupYou may have spotless documentat... Read more
MEETINGS:
Watch Out For Mistaken Carrier Denials for Polypectomies
CMS aims to pay claims with correct rate within two days after budget passesYour carrier m... Read more
CONSULTS:
Protect Your Consult Reimbursement By Educating Referring Physician's Staff
7 tips for complying with changed consult rules Consults used to have three R's for docume... Read more
TEACHING PHYSICIANS:
Boilerplate Answers On Teaching Physicians' Notes Could Boil Away Your Pay
Anesthesiologists must be personally present to bill based on timeA new clarification from... Read more
SURGERY:
No Global Package? Then Unwrap The Discharge Planning Codes
Make sure to document the surgeon's time if you bill 99238-99239Many surgeons believe they... Read more
Medicare Expands NTIOL Categories
More types of New Technology Intraocular Lenses (NTIOLs) will win coverage under Medicare ... Read more
CARDIOLOGY:
Reap Reimbursement Rewards For Remote Interrogation of Defibrillators
Avoid “reprogramming codes” 93742 and 93744 Did you know that new technol... Read more
ORTHOPEDIC:
READER QUESTION--Pull The Trigger On Improper Trigger Finger Coding
Question: The orthopedic surgeon evaluated a patient with trigger finger and scheduled her... Read more
PATHOLOGY:
Invest In V Codes For Better Payment Odds
The proof is in the medical necessity or patient historyIf you think V codes only provide ... Read more
UROLOGY:
READER QUESTION--Forgo Modifier Use When A Sedated Patient Cancels A Procedure
Question: A patient scheduled for an outpatient cystoscopic procedure was in the outpatien... Read more
OB-GYN:
End Endometrial Biopsy Coding Mistakes With This Update
New add-on code will make a difference to your denialsCPT made some changes to the way you... Read more
ONCOLOGY:
Learn The Basics To Block Blood Transfusion Blunders
Helpful hint:  Include both transfusion and blood product codes on your claimCoding f... Read more
PHYSICAL MEDICINE:
Reader Question--Understand Unit Numbers When Coding Therapy Services
Understand Unit Numbers When Coding Therapy ServicesQuestion: A therapist performed 8-minu... Read more
Part B Coding Coach:
Refresh Your NPP Incident-To Know-How With This 5-Step Checklist
Don't confuse other payors' regulations with Medicare'sCorrectly billing your non-physicia... Read more
PHYSICIAN NOTES:
Capture HPSA Bonuses By Documenting Exact Location Of Visit
Watch out for confusion between beneficiary's home and mailing addressesYou can still bill... Read more
REIMBURSEMENT:
You Won't Have To Resubmit January Claims To Gain Extra Money
Don't worry about collecting extra copayments from patients, CMS advisesHang in there--the... Read more
CONSULTS:
Watch Out For 56 Modifier Trap With Pre-Op Consults
Document primary care consults the same as specialist onesIf you think consults are just f... Read more
NEUROLOGY:
Physicians Can't Bill For Tests Performed By A Technician
You can't use separate code for mini mental status exams You may be used to the o... Read more
Emergency Rooms Earn A C Minus In National Survey
The American College of Emergency Physicians (ACEP) released its first "National Report Ca... Read more
LOCAL COVERAGE DETERMINATIONS:
You Can't Bill Temporary Pacemaker Or Anesthesia With Heart Catheterizations
Noridian expands stereotactic neurosurgery coverage Several of the Part B carriers de... Read more
MANAGEMENT:
Consider Charging Your Patients A Billing Fee For Copays, Deductibles
One practice adds percentages for collection agencies Your practice should set the ex... Read more
Physician Updates Could Vary By Region, Specialty
If the Medicare Payments Advisory Commission got its way, you would be receiving a 2.7-per... Read more
Part B Coding Coach:
Learn the Truth Behind These 4 Modifier 22 Myths--And Avoid More Denials
A longer-than-normal procedure does not automatically justify modifier 22 Did you kno... Read more
PHYSICIAN NOTES:
Health Care Spending Shows Signs Of Slowing
Growth rate down from 9.1 percent to 7.9 percent Changes in prescription drug use hel... Read more
AUDIOLOGY:
Don't Discount Diagnostic Aural Rehab Codes Just Yet
Keep track of time and new codes 92626-92627 can earn you extra cashWhen CPT 2006 changed ... Read more
MARKETING:
Should You Help Teach Seniors About Medicare Drug Benefit?
Watch out for conflicts of interest, experts warnYour Medicare patients are confused about... Read more
ONCOLOGY:
Confused By Cancer Care Demo Project? Help Is At Hand
Here are some important tips to capture demonstration reimbursementYour oncology or hemato... Read more
CARDIOLOGY:
Make Sure Documentation Supports ICD-9 Codes For Heart Failure
Carrier cracks down on LV lead placement claimsWhen you're reading your carrier's local co... Read more
Don't Bill DMERC For New Wheelchair Oversight Code
If you've been receiving denials for G0372 , the new code for physician oversight of powe... Read more
TRANSMITTALS:
Don't Bill A Consult Unless Your Documentation Backs It Up
You can’t bill a split/shared visit as a consult, but non-physician practitioners ... Read more
NEUROSURGERY:
Opt To Send An Operative Report When Using Modifier 22
Find out why including a cover letter can make all differenceYou know that surgical proced... Read more
ORTHOPEDIC:
23470 Eases Resurfacing Hemiarthroplasty Headaches
Helpful hint:  Look for Global CAP or Copeland in documentationIf you think that the ... Read more
INTERNAL MEDICINE:
You Be The Coder
Catch These Diabetes Manifestation Coding Clues Question: An internist’s docume... Read more
UROLOGY:
Be Aware Of Part B Billing Pitfalls For SNF Patients
Attach modifier 26 to request reimbursementBeware: When it comes to skilled nursing facili... Read more
OPTOMETRY:
How To Code For Co-Managing Back-to-Back Cataract Surgeries
You only have 90 days to perform postoperative careAccurately coding for cataract care dep... Read more
GENERAL SURGERY:
Settle On Modifier 78 For Subsequent Surgeries
Beware:  Don't charge separately for procedures in outpatient settings When ... Read more
Part B Coding Coach:
Say Hello to Higher Consultation Payments in 2006 With 6 Easy Steps
Now you can only report 1 initial consult code per admissionAttention coders: You will col... Read more
PHYSICIAN NOTES:
Physician Cuts Go Ahead As Planned, CMS Reports
Voluntary reporting program will be less complicated, notes ACPSince Congress failed to pa... Read more
PODIATRY:
Reader Question--Conquer Compression Therapy Coding With This Advice
Question: I have documentation for a patient who received compression therapy for a veno... Read more
DISCHARGES:
Don't Lose Money On Hospital Discharge Management
Be prepared to appeal downcoads from skeptical carriersWhen it comes to hospital discharge... Read more
REIMBURSEMENT:
Brace Yourself For A Lean January--And Hassles In February
Even if your payments are restored retoactively, will you be able to collect?So close, and... Read more
COUNSELING:
Document All Services Performed In Counseling Visit
If you don't hear back from the CERT contractor, you're probably in the clearIt's not just... Read more
RADIOLOGY:
NG Feeding Tube Bundled With Dozens Of Radiology Codes
CMS agrees to leave balloon angioplasty aloneHeads up, radiologists: Some of your most val... Read more
CMS Hits New Codes With 4,000 Edits At Once
According to a letter from the Centers for Medicare & Medicaid Services to specialty s... Read more
CCI 12.0:
CPT 2006 Gives And CCI 12.0 Takes Away
940 edits bundle many procedures with new skin graft codesCPT 2006 introduced four new cod... Read more
Part B Coding Coach:
Extract The Foreign Body Removal Answer You Need From These 5 Q&As
You can't report multiple FBR codes, but you still may be able to recoup extra when your p... Read more
PHYSICIAN NOTES:
Respiratory Physician Offered Cigarettes To Patients
Doctor, biller each face 10 years for Medicare fraudHeads up, billers: You're not immune t... Read more
Available Years:  2006  2005  2004  2003