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Part B Insider (Multispecialty) Coding Alert

Part B Payment:
Final MPFS Rule for CY 2017 Supports MACRA's Focus on Primary Care
E/M services, chronic coordination, telehealth at the heart of the finalized policies. ... Read more
Who Were the Winners and Losers in the Medicare Physician Fee Schedule?
Conversion Factor. Physicians can expect a slight increase this year with the conversion... Read more
Compliance:
OIG to Address Issues in Care Management, Prolonged Services, and More in 2017
The latest Work Plan focuses on several new areas of concern for the OIG. Starting Ja... Read more
E/M Coding:
3 Tips Lead to Seamless Consultation Coding
Consult coding is still going strong for some private payers—if you know how to re... Read more
Health IT:
Crunch Time: Get Ready For Advancing Care Information Now
You have two short months to prep for the implementation of MACRA’s final rule. ... Read more
Part B Coding Coach:
CPT® Updates: Relearn Angioplasty Coding to Prepare for 2017 CPT® Code Changes
Yet another group of intervention codes will bundle in S&I. When the calendar flip... Read more
Physician Notes:
CMS Has Released Its First Major Overhaul of Nursing Home Regulations Since 1991
CMS proposed the updates in July 2015 and received nearly 10,000 public comments, Andy S... Read more
E/M Coding:
Keep An Eye on HPI to Maximize Your E/M Claims' Values
Strong documentation is needed to fully address patients’ HPI to avoid claims&rsqu... Read more
Global Periods:
Optometry Mythbuster: Don't Perform Surgeries? Global Periods Still Apply to You
Even minor procedures have global periods associated with them. Myth: Because optometr... Read more
Compliance:
Don't Let Billing Blunders Bind Up Your Revenue Cycle
Insufficient provider notes are the top cause for compliance concerns, says CMS. As t... Read more
Part B Coding Coach:
Master the 'Multiple Scope' Rule with These Tips for Endoscopy Coding
For a better understanding of multiple scopes review codes 29805, 29806, 29807, and 2981... Read more
Physician Notes:
New AMA Tool Offers Advice on Which MACRA Model is Right For You
With MACRA’s Quality Payment Program (QPP) set to begin Jan. 1, 2017, Medicare pro... Read more
Part B Revenue Booster:
Smooth Sailing: Keep Your A/R Afloat or Suffer the Consequences
Take a look at these ideas to keep your accounts receivable in check. Easy-to-access ... Read more
Vaccinations:
Avoid the Aches and Pains of Flu Vaccine Coding with These Tips
Here’s a helpful checklist to assist with vaccine coding challenges. It’s... Read more
Roster Billing Helps Alleviate The Stress of Mass Immunization Coding
Flu shots have become almost as popular as annual wellness visits to fend off illness, a... Read more
Part B Coding Coach:
Get A First Look At Coding Changes Affecting Psychiatry in 2017
You may no longer be able to consistently report family counseling. As we slowly reach... Read more
Physician Notes:
CMS Offers Update on SSN Removal from Medicare Cards
Plus: New tools from the ONC hope to help providers address health IT issues Practice ... Read more
HIPAA Compliance:
Don't Let HIPAA Worries Plague Your Small Practice
Know these compliance basics to avoid HIPAA audits for smaller practices. Since every ... Read more
Revenue Booster:
Collecting Patient Feedback is Easy, But Make Sure It's Legal First
Use new technologies to help garner precious patient input and bolster your bottom line.... Read more
Part B Coding Coach:
CPT® Changes: Take Charge of CPT® 2017 Updates With a Cardiology Overview
Overlooking this moderate sedation news could cost you. From angioplasty to coronary I... Read more
Physician Notes:
ONC's Creative New Tool Keeps Providers Up-To-Date on Upcoming Quality Measures
Plus: California SNF corporation provided unnecessary treatment upwards of $30 million. ... Read more
Part B Payment:
Public Input Affects CMS Decision to Offer MACRA QPP Plan Options
As Jan. 1 approaches, CMS provides a Quality Payment Program pacing guide. With the f... Read more
Clip And Save:
What's On Your Revalidation Checklist?
Know the current revalidation requirements with this handy list of dos and don’ts.... Read more
Medicare Errors:
E/M Factors Largely in Part B's 2015 Fee-For-Service Error Rate
Though CERT data helped decrease errors, improper payments are still in the billions. ... Read more
Reevaluated GI Procedures Make Coding Moderate Sedation Easy
Be on the lookout for these six exclusive codes in 2017. Your endoscopy reimbursement ... Read more
Physician Notes:
CMS Program Determined to Reduce Hospital Readmission Trends
Currently, Medicare spends approximately $17 billion annually in avoidable hospital read... Read more
Compliance:
Is Your Practice Texting in Line with HIPAA Standards?
Ensure that you’re protecting yourself and your patients when you text. Mobilit... Read more
EHR Overload Affects Physicians' Performance, a New AMA Study Reports
Many enter the field of medicine with high hopes of engaging with the public on an altru... Read more
Modifiers:
Are You Up to Speed on Modifier 24?
Take a look at these examples to see if you are coding it correctly. Evaluation and m... Read more
Preventive Services Mythbuster:
Bust These Glaucoma Screening Myths to Secure Medicare Pay
Hint: Medicare may not view a year the same way your calendar does. Your eye care prac... Read more
Physician Notes:
HHS Moves Forward in the Fight Against Zika with Pediatric Funding
Plus: Social needs of CMS beneficiaries addressed in recent innovation model. As the Z... Read more
Part B Statistics:
Compare Your Physician Assistant's Modifier 25 Billing with Other PAs
Take a look at a recent CBR on physician assistants, E/M visits, and modifier 25. Ben... Read more
Revenue Booster:
Get a Grip on Global Periods
Know the seven global periods to ensure your claims are CMS-compliant. Seven—th... Read more
Part B Billing:
These 6 Quiz Answers Will Help You Decipher Duplicate Billing
Rate your results against the experts’ with the answers to last week’s quiz.... Read more
Part B Coding Coach:
Can't Find the Right CPT® Code? Don't Break a Sweat, Use an Unlisted Code Instead
Detailed documentation in your op notes will streamline your claim. Suppose an operati... Read more
Physician Notes:
Fla. Practice Must Pay $7.3 Million for Administering False Drug Tests
If a service falls into the grey area of Medicare and is deemed medically unnecessary, i... Read more
Modifiers:
There's More to Appending Repeat Procedure Modifiers Than Code, Code, Repeat
Distinguish between the different services and modifier options. Coding for repeat pr... Read more
Part B Billing:
Quiz: Test Your Duplicate Billing Knowledge
Avoid the need for appeals with this duplicate billing review. Duplicate billing rank... Read more
Part B Coding Coach:
Integumentary System: Master Melanoma Excision Reports With 3 Tips
Watch for separate repair charge. If your general surgeons treat some of the more than... Read more
Focus on Melanoma:
Malignant and In Situ Are Different Diagnosis Code Options
Most conditions report to a single code family in ICD-10-CM — but not melanoma. In... Read more
Physician Notes:
CDC Urges Providers to Educate Patients on Sepsis Risks
A tickle of a cough, a slight splinter, a stomach ache, a urinary tract infection—... Read more
Reader Question:
Are You Up to Speed on How to Bill J7050?
Question: I saw your advice to report J7050 with Remicade in the “Part B Codi... Read more
Affordable Care Act:
New PACE Update Focuses On Flexibility and Stability for Seniors
ACA implementations to PACE encourage embracing new technologies to protect the aging. ... Read more
Incident-To:
Watch Your Incident-To Claims When Your Physician Is Out of Office
Take a look at these points to refresh your staff on how to properly bill incident-to. ... Read more
Part B Coding Coach:
Don't Let Trach Tube Procedure Claims Get You Down
Expert advice on global days and bundling rules to ensure your trach tube claims are spo... Read more
Physician Notes:
Couple Gets Prison Time for Masquerading as Physicians in Portable X-ray Scam
Plus: CMS Releases 2014 Part D Drug Data The use of portable imaging has skyrocketed ... Read more
Reader Questions:
Know the Differences Between PT and Chiropractic Services to Avoid Denials
When referring patients to a chiropractor, make sure you understand what CMS covers. Q... Read more
Part B Payment:
Documentation Must Be Clear and Complete to Ensure Chiropractic Claims Are Accepted
With chiropractic claims, it is wise to consult your MAC on documentation requirements. ... Read more
Part B Revenue Booster:
Help, Hype, or Hindrance: Social Media Can Be the Key to Revenue Rewards
Ramp up your social media presence with this cyber advice. Due to the onset of social ... Read more
Clip And Save:
Get A Grip on MAC Vernacular to Avoid Denials
Know these top acronyms commonly found in MAC coding and provider resources. CMS utili... Read more
WPS Medicare Identifies This Major Coding Problem Among ENTs
Hint: Don’t skimp on documentation. Most coding experts have heard the old adage... Read more
Physician Notes:
CDC and FL Health Offer New Advice for Providers As Zika Hits First US Citizens
Plus: New MPPR rulings for PC will affect payment for some diagnostic imaging care. A... Read more
Part B Payment:
CMS Continues Its Focus on Primary Care with New Initiative
CPC+ model highlights the move to quality care with major monetary incentives. As Medi... Read more
Compliance:
Worried About the Loss or Theft of PHI in Your Practice Due to Cyberattack?
Ensure that you and your associates understand what’s at stake when PHI is comprom... Read more
Part B Coding Coach:
A Bonanza of Burr Hole Codes Make Cranial Coding a Breeze
  Watch the documentation to specify each particular cranial procedure.  Y... Read more
Physician Notes:
CMS Releases Final 2017 ICD-10 Code List
Plus: Part D prescription drug premiums remain status quo You’ve got only a few ... Read more
Reader Question:
Keep Updated with Part B Changes to Avoid Portable X-ray Denials
   Make the effort to educate your practice or group before claims are denie... Read more
Part B Payment:
CMS Continues to Shift Toward MACRA's QPP with Focus on Cardiac Care
Mandatory bundled payments offer incentives to providers that put quality over quantity.... Read more
ICD-10 Coding:
Quiz: Are You Up To Speed with ICD-10?
Test your knowledge with our handy ICD-10 coding quiz. Oct. 1, 2016—are you rea... Read more
HIPAA:
Are Your EHR-Contingency Plans HIPAA-Ready?
Consider these 5 HIPAA requirements when preparing for disaster. A catastrophe is def... Read more
Part B Coding Coach:
ICD-10: Let 'Z' Codes Support Your Ophthalmology Claims and Help Bring in Payments
These codes aren’t just to make your claims lengthier—they serve an importan... Read more
These Z Codes Can Make Your Day
Eye care practices that are unfamiliar with additional Z codes beyond the ones mentioned... Read more
Physician Notes:
CT Psychiatrist Charged with Fraud for Billing Over-the-Phone Care
With telehealth revised and repackaged in recent CMS rulings, what is acceptable to clai... Read more
HCPCS:
Look For New HCPCS Codes with the CMS Quarterly Update
Drug and biological additions are the highlight of the HCPCS changes. With the most r... Read more
Patient Engagement:
Manage These Part B Patient Questions with Ease
Here are some tips for answering 3 tricky beneficiary questions. You may be a whiz wit... Read more
Clip and Save:
Has MACRA Slang Got You In a Muddle?
Despite the suggestion that CMS is slowing down this Medicare payment train for further ... Read more
Part B Coding Coach:
Frequency Is A Factor When Coding Colonoscopies
Consider risk and frequency when choosing the right codes for colon-related procedures. ... Read more
Physician Notes:
Patient-Centered Ideas Thrive with the Rise of Quality Care
Plus: HHS pushes for more research in the fight to protect all health information. Mo... Read more
Macra Update:
Slavitt Open to MACRA Delays As Start Date Approaches
In testimony and Q/A, Slavitt offers insight into Medicare changes. If you’re c... Read more
Part B Payment:
Primary Care, Diabetes Are Central Themes of 2017 Proposed Fee Schedule
CMS continues to put the spotlight on patient health and quality care with proposals. ... Read more
Will You Be Impacted by the 2017 Fee Schedule Changes?
As CMS integrates MACRA-backed ideologies, quality care that puts the patient first cont... Read more
Compliance:
Confused About On-Call Coverage Arrangements?
Get the facts before you enter into an on-call payment agreement. Year in and year ou... Read more
Part B Coding Coach:
NGS Reviews Show 80 percent of Vascular Study Claims Are Improperly Coded
Here’s an outline of duplex scan coding to help you avoid denials. If you report... Read more
Physician Notes:
MLN Offers Weekly Provider Compliance Advice in New Outreach
Plus, HHS moves to stop the overprescribing of opioids. The Medicare Learning Network... Read more
Part B Statistics:
Where Do You Fall in the Value Rank Of Podiatry?
Palmetto advises with CBR to help you compare yourself to your peers. Have you ever w... Read more
Compliance:
Data Analytics Key To the Big OIG Takedown
CMS watchdog used enhanced analysis of Medicare billing to capture 300 fraud offenders. ... Read more
Nail Debridement Logs Appx. 50 Percent Error Rate
Despite its prevalence, nail debridement continues to be a source of coding confusion fo... Read more
Confused About Kickbacks and Self-Referrals?
Here’s a quick overview to keep you compliant. As the OIG cracks down on fraud ... Read more
Part B Coding Coach:
Pediatric Coding: How Do Your Results Compare To Other Pediatricians?
Use benchmarking tactics to determine your financial potential. Most pediatricians kn... Read more
Physician Notes:
HHS Offers MIPS Assistance To Small Practices
In an effort to reach out to the little guy, the Department of Health and Human Services... Read more
X-RAY Coding:
Focus On the Fine Print To Bill Portable X-Ray Claims Properly
CMS portable x-ray rules can be confusing if you don’t know what to report.  ... Read more
Avoid Denials With The Right HCPCS Portable X-Ray Codes
Know how to bill transportation and set-up to ensure your claims are accepted. For po... Read more
Compliance:
SMP Update Highlights Changes and Recoveries
The Senior Medicare Patrol continues to make strides and recoveries. Since its formati... Read more
Medicare Funding:
Can Medicare Make It To 2028?
Slow cost growth continues for Medicare programs, says Trustees’ Report. The lat... Read more
Part B Coding Coach:
Dual-Provider Coding For E/M Services
Here’s the difference between ‘concurrent,’ ‘duplicative.’... Read more
Physician Notes:
OIG Escalates The Attack Against Fraudulent and Abusive HHAs
Plus: Is telemedicine the future of healthcare? The rise of Home Health Agencies (HHA... Read more
Patient Engagement:
ONC's New Playbook Offers Guidelines for Your Patient Portal Launch
Patient engagement will be key as ACI initiatives go into action next year. As the in... Read more
Turn Around Your Patient/Provider Relations
Tips to improve patient engagement with a fully utilized patient portal. As the result... Read more
The AMA Chimes in on Health IT
Madara outlines the AMA’s plans to help physicians with the onset of changes. T... Read more
Part B Coding Coach:
Compare Your Eye Care Practice's Billing Trends Against These National Averages
Benchmarking can help you see where you stand in relation to other practices. Many eye... Read more
Physician Notes:
MLN Videos Advise on Avoiding Denials
Plus: OIG crackdown on referral bribes nets $12 million in recovery The Medicare Learn... Read more
Advice from Palmetto For Tricky E/M And Eye Codes
Many optometry practices struggle with the question of to use standard E/M codes for the... Read more
Reader Question:
Clarify Your LT Claims Concerns
Question: One of the physicians in our practice will be out of the country for nine... Read more
Part B Billing:
Don't Let Locum Tenens Rules Spoil Your Summer Vacation
LT restrictions made easy with these tips for filling physician vacancies. The onset o... Read more
Compliance:
OIG Crackdowns Yield Major Results in the Fight Against Medicare Fraud
Big cash recoveries expected for CMS this year, says the OIG Semiannual Report. With b... Read more
ICD-10:
Prepare For These 6 Ob-Gyn ICD-10 Changes Effective Oct. 1
October revisions will keep the denials at a minimum. Remember how you had thought you... Read more
Part B Revenue Booster:
Turn Around These 5 Basic Blunders to Improve Your Cash flow
Learn how common coding mistakes can hurt your practice budget. As the healthcare ind... Read more
Zika Virus Update:
Zoned-out About Zika?
Provider resources and codes abound to deal with summer Zika virus woes. School&rsquo... Read more
Compliance:
Lack of a Practice Compliance Program Puts You at Risk
New OIG policy statement outlines the importance of compliance planning. Due to the c... Read more
Part B Coding Coach:
General Surgery: Some CCI Edits Can Cause Trouble
Be aware of modifier 59 as an option to help navigate the changes. When your general s... Read more
Physician Notes:
AHRQ Resource Aids Providers When Accidents Happen
Plus: CMS Updates ICD-10 with Specialty Support Mistakes are made, and sometimes lives... Read more
Inpatient Coding:
Distinguish the Fine Line Between Inpatient and Outpatient Stays
Misunderstood documentation could lead to accusations of overpayments. It’s been... Read more
ICD-10:
Will Your ICD-10 Claims Be Accepted After Grace Period Ends?
Don’t forget: MACs are still going easy on denials. If your ICD-10 denials are l... Read more
Measure Your 'KPIs' to Track Your Progress
Not sure where you stand in terms of your ICD-10 progress at this point? CMS offers deta... Read more
Compliance:
Levinson: These Are The 4 Biggest Healthcare Compliance Issues
Highlights from OIG chief’s keynote at the 20th annual HCCA Compliance Institute ... Read more
Part B Coding Coach:
Focus on Crohn's Coding: Diagnosis, Management, and Treatment Codes for Review
Location is key to understanding these ICD-10 codes. Your Crohn’s disease (ileit... Read more
Physician Note:
Firearm Safety Case May Impede Provider and Patient Dialogue
Plus: Anesthesiologist gets 100 months for fraudulent Opioid prescriptions In yet ano... Read more
E/M Services:
CMS: You Needn't Hold Transitional Care Management Claims for 30 Days
Date of face-to-face service can now be your DOS. Tracking your practice’s trans... Read more
Compliance:
3 Common HIPAA Breaches -And How to Avoid Them
As the OCR’s Audit Phase 2 looms large, watch your practice’s loopholes for ... Read more
Are You Breach Bound?
A HIPAA-compliant BAA will help you avoid breach burn. Unauthorized access and disclos... Read more
Part B Coding Coach:
Focus on These Updates to ICD-10 Codes for Eye Care Specialists
Here’s a closer look at your coding options in Ophthalmology. New and expanded d... Read more
Physician Notes:
Review Your Data Before Open Payments Go Live on May 15
Plus: Chiropractor charged with laundering health care payments. As the 45-day window ... Read more
Breaking News:
MACRA Boosts Its Capital By Putting Value and Quality First
HHS proposed rule outlines Medicare’s new Quality Payment Program. After much re... Read more
Part B Statistics:
Palmetto: 21 Percent of Internal Medicine E/Ms Included Modifier 25
Use this MAC’s data to compare your billings to other internists nationwide. Eve... Read more
Goodbye Meaningful Use, Hello Advancing Care Information
This new MIPS initiative offers more options and assistance for participating practition... Read more
Physical Therapy:
OIG Cautions PT Practices to Align Policies and Procedures
Incomplete claims documentation and confusion can lead to big financial losses. Unders... Read more
Part B Coding Coach:
Mastering Migraines: The Importance of the 4th Character in ICD-10 Coding
Understanding Character No. 4 is essential to select the right diagnosis code. When yo... Read more
Physician Notes:
Changes to the JW Modifier Put Money Back in the Pocket of Providers
Plus: AMA warns that a TN liability case could lift the limits on awards against physici... Read more
Patient Privacy:
HIPAA Audits to Scrutinize the Fundamentals of Your Privacy Plans
Ensure that your program discusses how to cover these details to prep for an audit. Do... Read more
Check out HHS's Sample Business Associate Tracker
Use the government’s template to create your own tracking system. One of the HIP... Read more
Healthcare IT:
ONC Spearheads Effort to Improve Healthcare Technology
Demands for digital transparency continue to revolutionize healthcare. Due to the ever... Read more
Annual Wellness Visits:
This MAC Reminds Practices to Use Caution Billing Separate E/M With AWV
Remember not to overlap history, exam when determining E/M level. When a patient prese... Read more
Part B Coding Coach:
Looking Ahead: 7 ICD-10-CM Revelations for 2017 That Change Cardiology
Dreams do come true—new stent codes that will make your coding easier. The CDC h... Read more
Physician Notes:
New Medicaid Rule Rewards Providers for Quality Care
Plus: Miami physician gets prison time in Medicare scam In an effort to provide greate... Read more
Cyber Challenges:
Ideas from the ONC to find the right Health IT products for you
This April, the ONC, in coordination with the Medicare Access and CHIP Reauthorization A... Read more
Breaking News:
Say Hello to 1,900 New ICD-10-CM Codes Effective Oct. 1
CDC ends diagnosis deep freeze with scores of new codes debuting. Coders patting thems... Read more
Part B Revenue Booster:
This Solo Practitioner Brings in Millions a Year With a Few Simple Strategies
Hint: When you code based on time, everyone wins. The old saying goes “haste ma... Read more
Perfecting Your Technical Composition
How to utilize dictation software to revolutionize your practice If your E/M codes are... Read more
The Merge of Money and Modifiers
Integration leads to quicker billing. If your office technology is integrated througho... Read more
CCI Edits:
Some Medicaid Payers Aren't Properly Implementing CCI Edits, OIG Says
Look out: CMS to start ensuring that states adhere to CCI bundles more carefully. When... Read more
Part B Coding Coach:
For Multiple Fracture Repairs,Take Into Account E/M and Modifier 51
Don’t miss this 2016 Medicare guidance for global fracture treatments. Miscoding... Read more
Physician Note:
Rampant E/M Overbilling Prompts Violations and Millions in Fines
Plus: 99211 is not your friend for infusions. The Justice Department continues to crac... Read more
Part B Payment:
CMS Launches Primary Care Model, Impacting 20,000 Clinicians
You’ll be able to apply for the track most applicable to you within the next few m... Read more
Chiropratic Coding:
3 Takeaways From CMS's Recent Chiropractic Directives
Hint: Make PART your friend. Both the OIG and CMS have repeatedly announced that chiro... Read more
Compliance:
OIG Aims to Lower Medicare Pay for Procedures Performed in Hospital Outpatient Departments
Plus: EHR security issues remain a problem. The OIG makes scores of recommendations ev... Read more
Part B Coding Coach:
Nail Your Percutaneous Biliary Stent Coding With 4 Tips
Code per session, not per stent. In the massive code overhaul of percutaneous biliary ... Read more
Physician Notes:
AHA Warns About New Digital Attacks
Plus: Education is key to avoiding ransomware attacks. As hospitals strive to becom... Read more
Reader Question:
Wondering About Giving EOB Explanations to Patients? Here's How
Question: We often get patients who call the practice with questions about their ex... Read more
Reader Question:
Documentation Should Focus on Substance, Not Style
Question: My physician reported an established patient office visit code 99214, but... Read more
Compliance:
CMS: Stop Reporting Diagnostic Colonoscopies for Screenings
Plus: Nerve conduction studies and observation services are also under the agency’... Read more
Face-To-Face:
MACs Deny Staggering 92 Percent of Claims Under F2F Audits
One MAC maintains nearly a 100 percent denial rate. The face-to-face physician encount... Read more
Your F2F Note Must Include These 5 Elements
The agency can’t enter the documentation for you in most cases. Under the new fa... Read more
Part B Coding Coach:
Identify the Provider to Assign the Right Code for Psychological Tests
Hint: Don’t report additional code for interpretation of technician administered t... Read more
Physician Notes:
Medicare Advantage Pay to Rise by 0.85 Percent
Plus: Texas physician sentenced to 12 years in prison for Medicare fraud. Looking for ... Read more
Reader Question:
Colonoscopy Won't Be Payable for Acute Diarrhea
Question: Our patient had diarrhea and the physician ordered a colonoscopy. Now the... Read more
Reader Question:
Watch Your Infusion, Hydration Claims
Question: It is possible to bill for non-chemo infusion 96365 and 96367 and hydrati... Read more
Patient Privacy:
It's Official: HIPAA Audits Are in Full Swing
Here’s how you can be ready in case an audit comes your way. You’ve been h... Read more
Hackers Demand Ransom in Exchange for PHI
What would you do if you were hit by a ransomware attack? You’ve heard of ransom... Read more
E/M Coding:
Can You Code These 3 E/M Scenarios?
Read the documentation and select a code before you read our solution. If you’re... Read more
Part B Coding Coach:
Pick Up an Ethical $400 By Applying the Lessons from This EGD Op Note
Tip: “Sample collection” is different from an actual biopsy. When your ga... Read more
Physician Notes:
Oklahoma Slashing Medicaid Pay
Plus: Physician under fire for outsourcing surgical monitoring services. Providers in ... Read more
Recovery Audit Contractors:
RAC: The Doctor Isn't in? Don't Bill E/M for Diagnostic-Only ED Visits
If the patient is triaged but never sees a qualified healthcare professional, don’... Read more
Appeals:
NGS: You Can Add Modifiers, Op Notes Only During This Stage of Appeal
One Part B MAC illuminates the five appeal stages in crystal clear detail. It happens ... Read more
Correct Coding Initiative:
2 CCI Updates You Should Know
Check out these cardiology and pathology updates that could impact your claims. The Co... Read more
Part B Coding Coach:
Take the Pain Out of Hemorrhoid Procedure Coding With 5 Quick Tips
Location takes precedence over all other conditions, even number. While reporting hemo... Read more
Physician Notes:
CMS Adds CRNAs to Telehealth List
Plus: CMS beats its goal of tying 30 percent of payments to quality of care. Practices... Read more
Hipaa Compliance:
Report: Many Practices Are Unprepared for Coming HIPAA Audits
 No privacy officer? Then you aren’t HIPAA compliant. As Part B practices n... Read more
8 HIPAA Training Skills That You Can't Afford to Ignore
Helping your staff stay up-to-date with HIPAA training is essential, and you must ensure... Read more
Modifiers:
CMS Says 'Use Modifier 51'--Some MACs Say 'Not So Fast'
Conflicting information can be confusing about the multiple procedures modifier. Coder... Read more
Cardiology:
CMS Solidifies Coverage for LAAC Using 0281T
Latest decision memo finally illuminates payment rules for left atrial appendage closure... Read more
Part B Coding Coach:
Focus Your Liver Resection Coding With 4 Easy Steps
Distinguish blocks, specimens for stains. When your pathologist examines a liver resec... Read more
Physician Notes:
What Ever Happened to 'Sequestration' Cuts?
Plus: CMS creates proposal for new medication injection payments. Do you remember back... Read more
Reader Question:
'G' Codes Point the Way to Bell's Palsy Dx
Question: Our neurologist diagnosed a patient with Bell’s Palsy. Can you advise ho... Read more
Medical Records:
HHS: Provide Patients With Medical Records at No Charge
Although you can legally charge patients for sending their records, HHS appears to disco... Read more
How Much Can You Charge?
The Department of Health and Human Services allows practices to charge a fee to provide ... Read more
What If the Patient Disagrees With the Information in Her Records?
It happens from time to time—you share a copy of the patient’s medical recor... Read more
Observation Care:
Don't Make this $259 Observation Coding Mistake
WPS Medicare outlines exactly why one provider’s documentation didn’t pass m... Read more
Learn From This Observation Coding Example
To get a firm grip on the observation coding regulations, take a look at this example an... Read more
Part B Coding Coach:
Remember 3 Things to Simplify Your Paravertebral Facet Joint Injection Claims
Here’s what you need to know when coding intra-articular blocks. You probably se... Read more
Physician Note:
Relay Health Sees Just 1.6 Percent of ICD-10 Claims Denied
Plus: CMS reminds practices that OIG is still using analytics software to find errors. ... Read more
Documentation:
3 Recordkeeping Tips That Will Make Auditors Smile
Instituting these simple strategies ensure that you’re ready for any type of revie... Read more
E/M Coding:
Yes, You Can Report E/M Codes When Talking to Family About Patient Care
As long as the patient is present, CMS allows you to bill an E/M code based on time. I... Read more
Nurse Visits:
4 FAQs Lead You to Trouble-Free Nurse Visits
Don’t forget to collect a copay when you see the nurse. The nurses at your pract... Read more
Part B Coding Coach:
Help Yourself to These 27033, 27125, 27132 Coding Insights
Can you report an osteotomy with a previous hip surgery conversion to total hip arthropl... Read more
Physician Notes:
EHR Hardship Exception Application Doesn't Prevent You From Meeting MU Requirements
Plus: 12.7 million Americans chose healthcare plans through the Health Insurance Marketp... Read more
Reader Question:
Some Payers May Want Modifier 25 Despite Add-on Nature
Question: United Healthcare recently denied a claim, saying that we should have add... Read more
Compliance:
Stick to 4 Tips for Compliance Bliss
Watch the timing of chart signatures, CMS advises. Navigating the compliance rules has... Read more
ICD-10 Coding:
Don't Automatically Assign Admitting Diagnosis on Discharge Claims
A patient’s diagnosis can change over the course of a hospitalization. Just beca... Read more
Anesthesia:
Consider the Timing Before You Bill for Cancelled Anesthesia
Pinpoint exactly when the procedure was halted to find the right billing strategy. As ... Read more
Part B Coding Coach:
Check the Technique Before Submitting 30901 for Repair
Plus: Don’t forget you have different codes for posterior bleeds. A patient come... Read more
Physician Notes:
CMS: Start Searching Now for Overpayments--Or Face Penalties
Plus: Phone app developers could be considered business associates in certain instances.... Read more
Reader Question:
You Can Carry Over PMFSH From Previous Encounter--to an Extent
Question: Our doctor documents the electronic medical record (EMR) really well in t... Read more
Part B Carriers:
Yes, You Can Choose to Limit New Medicare Patients
This and other answers are all yours—straight from the MACs. When it comes to Me... Read more
Part B Revenue Booster:
"Has Your Insurance Information Changed?" May Be the Wrong Question to Ask Patients
Ask pointed questions to get better information from patients, this billing expert says.... Read more
ICD-10:
Your Physician's Notes Reveal Diagnosis Codes -- You Just Have to Know Where to Look
If the doctor does not circle a diagnosis, it may be up to you to find one. Don’... Read more
Part B Coding Coach:
Implement Code Changes for Your Bronchial and Mediastinal Scope Cases
Pinpoint EBUS services with these codes. If your surgeon performs scope procedures in ... Read more
Physician Notes:
CMS: Stop Balance Billing QMB Patients
Plus: Louisiana health network discloses possible HIPAA breach. If you see qualified M... Read more
Reader Question:
You Won't Find Laparoscopic A&P Repair Code
Question: Our gynecologist’s op note states, “Laparoscopic Uterosacral ... Read more
E/M Coding:
NGS Medicare: Majority of 99215 Claims Were Coded in Error
Use our expert tips to avoid the issues that plagued high-level claims. When payers an... Read more
Error Rates for Hospital E/M Codes Were Even Worse
Although the 65 percent error rate for code 99215 seems astronomical, the reality is tha... Read more
Patient Privacy:
Discover These 3 Common Ways That Practices Violate HIPAA
Hint: You should train your temps if they aren’t already hip to HIPAA. Now that ... Read more
CCI Update:
Watch for Corneal Ring Segment, Collagen Cross-Linking Bundles
Tip: You can report a Column 2 code with a Column 1 code – but only under certain ... Read more
Part B Coding Coach:
Answer These Top 3 Questions to Test Your Understanding of Chemotherapy Administration
When reporting multiple infusions, choose initial administration service code to represe... Read more
Physician Notes:
Duplicate Claims Can Cause Double the Trouble
Plus: Medical practices continue to boost IT budgets. Medicare is just as eager to pay... Read more
Part B Revenue Booster:
Boost Your A/R Now With These 10 Expert Tips
If you don’t scrutinize your accounts receivables, you’re probably losing&nb... Read more
How to Quickly Calculate Your Days in A/R
Collections can be hard enough to manage without mastering all the jargon as well. But w... Read more
Modifiers:
3 Quick Tips Keep Your Modifier 26 Claims Above Board
Hint: Don’t use this modifier in your office. Many coders know that modifiers 26... Read more
Clip And Save:
This Simple Tool Can Lead You to the Correct Modifier 26 Usage
If you struggle to pinpoint the right times to append modifier 26 (Professional componen... Read more
Part B Coding Coach:
Charge Up Your Cardioversion And Defibrillation Coding With These Tactics
Can you identify the difference in these procedures to code accurately and prevent denia... Read more
Physician Notes:
CMS Debuts New Face-to-Face Home Health Clinical Template
Plus: Payer misplaces PHI of nearly one million patients. Physicians who certify patie... Read more
Reader Question:
Look to CCI for Brace Bundles
Question: Can my physician bill for a fitting and education of a brace during the p... Read more
ICD-10:
10 Steps Ensure ICD-10-CM Coding Compliance
You’ve made the transition to the new diagnosis coding system—now make sure ... Read more
Inpatient Coding:
Achieve Seamless Inpatient Coding in 5 Easy Steps
Office E/M codes may come easily to you—but investigate your hospital coding prowe... Read more
Part B Coding Coach:
Heighten Your Chance to Heel Spur Treatment Claim Success With This Advice
Rule out fracture, and check for casts and orthotic devices. If you’re reporting... Read more
Hone in on Heel Spurs
Heel spur, also called calcaneal spur, may be caused by the tears in the origin of the p... Read more
Physician Notes:
Get Ready for Overhauled EHR Incentive Program
Plus: CCI takes aim at new prolonged service codes. CMS projects that by the end of th... Read more
Coding Errors:
Practices Shorted Themselves Nearly $210 Million in Downcoded E/M Visits Last Year
CERT results reveal that insufficient documentation topped list of Part B errors last ye... Read more
Compliance:
CMS: Stop Reporting Hospital E/M Codes for SNF Visits
Plus: Laparoscopic hernia repairs are under the agency’s microscope. Many provid... Read more
Patient Privacy:
OIG Calls for More HIPAA Enforcement
Watch for agency to get more aggressive, experts caution. As if you didn’t have ... Read more
ICD-10:
Sprain and Strain Diagnoses Flourish Under ICD-10
You’ll now find over a dozen codes just for neck pain. You cannot afford to take... Read more
Part B Coding Coach:
Watch These 4 Group Psychotherapy Myths That Could Prove Costly
Hint: Use HCPCS codes for group psychotherapy in a partial hospitalization setting. Wh... Read more
Physician Notes:
Doctor to Repay Government $3.75 Million for Unnecessary Tests
Plus: ACOs will treat 9 million people, thanks to addition of new organizations. A Vir... Read more
Advance Care Planning:
Collect Coinsurance for ACP Visit--Unless You Meet This Exception
Whether or not you provide the service during an annual wellness visit makes all the dif... Read more
Electronic Health Records:
3 Tips Help You Stay Sane If Your EHR Goes Offline
No one wants an EHR to go down, but you can avoid panic with these simple steps. You... Read more
Part B Coding Coach:
4 Tips Help You Claim Colorectal Cancer Screening Payment
Look out for screening tests that are not covered for payment. Billing colorectal canc... Read more
Physician Notes:
New 'Excludes1' Guideline Could Change Your Diagnosis Coding
Plus: House of Representatives votes to repeal the ACA. You’ve been using ICD-10... Read more
Reader Question:
CMS Reps Address Time Thresholds for Advance Care Planning
Question: The new advance care planning code (99497) descriptor refers to “fi... Read more
Reader Question:
Don't Change POS for SNF Patient in Office
Question: Thank you for your recent article about audits on E/M services performed ... Read more
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