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Part B Insider (Multispecialty) Coding Alert
Part B Insider (Multispecialty) Coding Alert
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Orthopedic Coding Alert
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Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 12
Fraud & Abuse:
Register Possible AKS, CMP Changes in New Proposal
See new safe harbors to promote value-based care. The feds are on a mission to reduce adm...
Read more
Stark Law Update:
Know What's on the Table with Stark
Get the facts on what ‘commercially reasonable' means. If you've been waiting anxiously...
Read more
E/M Coding:
Tackle Prolonged Service Issues With 3 Tips
Hint: Check guidelines for add-on codes. Now and again, you may need to spend more time w...
Read more
Clip and Save:
Be Aware of These 18 PHI Identifiers
Remember, IP addresses constitute PHI. With data breaches on the rise, it's become even m...
Read more
Part B Coding Coach:
Review Possible Additional Services With This Q-and-A
Know how to code secondary issues in fracture encounters. There's no denying that fractur...
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Physician Notes:
AIC Thresholds Go Up in 2020
Reminder: CMS updates the AIC threshold amounts annually. If you're filing an Administrat...
Read more
Reader Question:
Find Out About Medicare's Colonoscopy Criteria
Question: What documentation do we have to provide for a Medicare patient to justify a scr...
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Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 11
Compliance:
New Rule Stops Fraud Before Enrollment
Tip: Check into your partners' business dealings to avoid problems. The feds continue to ...
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E/M Coding:
Know the Top E/M Revisions in CPT® 2020
Hint: Reporting online E/M, monitoring will be different next year. The 2020 CPT® c...
Read more
Medicare Mythbusters:
MAC Debunks 8 Common Medicare Myths
Tip: There's more to Medicare than just Part B. If you think that Medicare Advantage is j...
Read more
Part B Coding Coach:
When Can Bronchoscopies and Thoracotomies Be Billed Together? Find Out
See how modifier 59 factors into these billing scenarios. Most pulmonology coders wouldn'...
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Physician Notes:
Start Using Patients' MBIs Before the Transition Ends
Tip: Use MBIs on referrals, too. If you're not using your patients' Medicare Beneficiary ...
Read more
Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 10
Evaluation & Management:
Feds Nix E/M Blended Payment Proposals
Hint: Expect the 2020 rule to fix other E/M issues, too. Recent evidence suggests that yo...
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Review 5 Fee Schedule Key Points
CMS keeps pushing its policy rollback revolution. Though the E/M updates are a hot topic,...
Read more
Part B Policy:
Check Out 4 Care Management Proposals in the 2020 MPFS
Hint: CMS aims to change CM with overhauls and a new option. If care management services ...
Read more
Part B Coding Coach:
Cardiology: 3 Tips Boost Your EP Coding Skills
Tip: 5 components are necessary to report a comprehensive EP study. If you find intracard...
Read more
Physician Notes:
Plan for MFA Prompts for Part B Provider Online Enrollment
Check with your MAC for implementation woes. Hackers continue to target healthcare with m...
Read more
Reader Question:
Tackle Tick Bites with These Tips
Question: When a patient has a tick bite and the clinician orders a test for suspected Lym...
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Reader Question:
Check MAC Advice on Refills and MDM
Question: Can you count a routine prescription refill as a moderate level of risk when det...
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Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 9
Reimbursement:
Find Out Your Chances of a MIPS Audit
Tip: Keep your files on hand for at least six years. If you're busy submitting Merit-Base...
Read more
CPT® 2021:
Look for 3-Part E/M Guidelines in the Future
Summary details plan to bring more order to E/Ms. CPT® plans to split evaluation and man...
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Compliance:
Understand How Fraud and Abuse Are Different
Hint: ‘Gang visits' aren't what you think. You may think that CMS is easing up on compl...
Read more
RAC Audits:
Auditors Home in on Modifiers for Discontinued Procedures
Find out what RACs are reviewing. Occasionally, you're forced to discontinue a procedure ...
Read more
Part B Coding Coach:
Address 99285 Concerns With 3 Tips
Tip: Ensure your documentation backs up the higher-level E/M code. Whether you bill 99285...
Read more
Physician Notes:
Remind Your BAs and Vendors About New MBIs
Tip: Fix your claims problems now. Statistics shows that providers are doing a great job ...
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Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 8
ICD-10-CM Coding:
Check Out New Heatstroke, Poisoning Code Options Available Oct. 1
The 2020 diagnosis code list includes nearly 400 changes. CMS is expanding your coding op...
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Enforcement:
OIG Targets False Claims in New Report
Don't underestimate the importance of proving medical necessity. If you're waiting for th...
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HIPAA:
Master 4 Contracts for Security and Privacy
Tip: Factor cybersecurity into your BAAs. HIPAA compliance planning and training can help...
Read more
Part B Coding Coach:
Know These Dos and Don'ts of Special Services
Plus: Three coding tips that help you go beyond the guidelines. There are six after-hours...
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Physician Notes:
Late Signature Issues Are on the Rise
Tip: Submit attestation instead of adding signature after the fact. One Medicare Administ...
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Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 7
E/M Coding:
See What's Ahead for E/M in 2021
Hint: 99201 exits the coding stage. If you thought the Medicare Physician Fee Schedule (M...
Read more
Compliance:
Review 4 Tips to Ace ABN Quandaries
Tip: Follow Medicare's rules to avoid ABN issues. Now and again, your practice may perfor...
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Part B Coding Coach:
Sidestep Miscoding Woes with Radial/Ulnar Fx Fixes
Tip: Patient could suffer from an open or closed fracture. Documentation is key in health...
Read more
Physician Note:
CMS Offers New Guidance on Co-Location Requirements
Sharing public areas, services, and staff with other healthcare entities is complicated. N...
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Physician Note:
Safe Harbors' Proposed Rule Slated for Possible July Release
The feds are set to release the long-promised revisions to safe harbors under the Anti-Kic...
Read more
Physician Note:
MAC Warns Physicians About Home Health Referrals
When referring Medicare beneficiaries for home health care, it's all in the details. In a ...
Read more
Reader Question:
See the Q6 Guidance on NPPs' Services
Question: We'd like to report a nurse practitioner's (NP) services to Medicare with a locu...
Read more
Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 6
HIPAA:
CMP Reductions Signal New Direction for HIPAA Enforcement
Hint: Assess and manage risks or pay the price. In 2018, the feds set records with their ...
Read more
Compliance:
Know the Facts on MIPS Audits
Hint: Keep detailed notes and dates for back-up. Part B providers have a lot on their pla...
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Implement 5 Documentation Tips to Tackle MIPS Audits Head-On
Your Merit-Based Incentive Payment System (MIPS) attestations may be airtight, but...
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Part B Coding Coach:
Breathe Easy with This Seasonal Allergy Coding Advice
Hint: Allergic rhinitis codes are nothing to sneeze at. What do sniffles, watery eyes, an...
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Physician Note:
Soaring Measles Outbreak Remains an Issue in 23 States
Measles — once considered eliminated in the United States — is back with a vengeance a...
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Physician Note:
Feds Extend Comment Period on Interoperability Proposals
Do you need more time to peruse the interoperability rule that CMS released in February? T...
Read more
Physician Note:
CMS Gets in on the Podcast Craze
If you haven't heard, CMS is now offering policy highlights, thoughts, and ideas via podca...
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Reader Question:
Who Can Record a ROS? Find Out
Question: There is a debate in our office about who can record an ROS. Can you help us? C...
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Reader Question:
Know When It's Ok to Write Off a Patient's Bill
Question: We have had a few patients who don't pay their bills, even if we offer discounts...
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Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 5
Appeals:
Know the 5 Levels of the Medicare Appeals Process
Hint: Reopen first, before you try for an appeal. If you find the Medicare appeals proces...
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E/M Coding:
Use CBR Insight to Back Up Your Claims
Tip: Turnaround E/M blunders with benchmarking numbers. If you feel like Medicare claims ...
Read more
Part B Coding Coach:
Don't Let Unlisted Procedures Impact Your Paycheck
Home in on these five details for coding success. Unlisted procedures might seem like the...
Read more
Physician Notes:
CMS Gets In on the HIPAA-Audit Game
Plus: MAC Satisfaction Indicator survey is up and running for 2019. If you weren't keen o...
Read more
Reader Question:
Master Prolonged Service Coding to Avoid Denials
Question: We have a new gastroenterologist who seems very fond of adding prolonged se...
Read more
Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 4
Compliance:
Boost 3-Year Rule Knowledge with This Primer
Tip: Review CPT® guidelines for best results. Choosing the right E/M code is daunting, b...
Read more
Interoperability:
Data-Sharing Issues Prompt Coordinated Proposals
CoPs may be revised to accommodate the health IT proposals. CMS has been on a health IT r...
Read more
Clip & Save:
Review 5 Provider-Audit Hot Spots
Hint: E/M coding is a perennial Medicare claims audit favorite. Medicare Part B coders sh...
Read more
Part B Coding Coach:
Master Sepsis Coding with This Primer
Hint: Key facts can assist with sepsis coding regulations. With annual ICD-10 changes, co...
Read more
Physician Note:
Submit Your MIPS 2018 Data Before It's Too Late
If you haven't submitted your Merit-Based Incentive Payment System (MIPS) data for...
Read more
Physician Note:
CMS Offers New Option for Online ADR Letter Exchange
CMS's burden-reduction rodeo continues with new ways to share documentation requests. You...
Read more
Reader Question:
Counter Consultation Catastrophes with Office and Inpatient Mastery
Question: What is the difference between an office consultation and an inpatient consultat...
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Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 3
Targeted Probe and Educate:
Subsequent Care Coding Remains a Popular TPE Focus Area
Hint: Incorrect coding tops the denial reasons for these codes. Billing subsequent hospit...
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E/M Coding:
Keep Claims Clean with These 3 Tips
Know what ‘interval' means. Coding for subsequent hospital care isn't easy, and many co...
Read more
Compliance:
Calculate Your Audit Odds with Expert Advice
Tip: Gauge your stats with Medicare utilization data. With audits on the rise, CMS remain...
Read more
Part B Coding Coach:
Review These New PTP Edit Pairs
CCI 2019 adds biopsy, care management, and psych test codes to the list. With 45,727 addi...
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Physician Notes:
CMS Offers New Medicare Enrollment App For Physicians and NPPs
Hint: CMS promises an easier process with new form. If you thought the old Medicare Enrol...
Read more
Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 2
Enforcement:
Modifier 59 Case Highlights Risks of Unbundling
Organization receives $12.5 million settlement for modifier 59 abuses. Now that you've ma...
Read more
Compliance:
Consider This Expert Advice for Modifier 59 Mastery
Ensure your documentation supports modifier 59 usage. Before you append modifier 59 (Dist...
Read more
Reimbursement:
E/M Services Factor Heavily in Improper Payment Numbers
Mistakes are still in the billions, but the error rate is declining. If E/M services are ...
Read more
E/M Coding:
Quell E/M History Quandaries with PFSH Basics
Tip: Review Medicare guidance for in-depth knowledge. Clear and concise documentation of ...
Read more
Part B Coding Coach:
Master Oculoplastic Coding with 3 FAQs
Hint: Not all plastic surgeries are considered cosmetic. Recouping payment for surgeries ...
Read more
Physician Notes:
Heed Updated MAC Advice on MBIs
Caution: Don't report HICNs and MBIs on same claim. Now that CMS has finished up its new ...
Read more
Part B Insider (Multispecialty) Coding Alert - 2019; Volume 20, Number 1
Part B Payment:
CMS Overhauls QPP's Promoting Interoperability ... Again
Plus: 2015 Edition CEHRT is now a reality for 2019. If your head is spinning from all the...
Read more
Recovery Audit Contractors:
RACs Zero in on Modifier 57 Usage
Study CPT® guidance for a better understanding of this tricky modifier. Not only do modi...
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Avoid Modifier 57 Snafus with Global Surgery Know-How
Peruse the 10-day versus 90-day global package details. A review of global surgery distin...
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Appeals:
Thoroughly Investigate Your Denials with These Expert Tips
Hint: Back up your claims with solid evidence. Maybe you've always wanted to do some priv...
Read more
Part B Coding Coach:
Master Common Winter Woes with This Coding Chart
Boost your documentation with tips from the experts. During the season of giving, some of...
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