Part B Insider (Multispecialty) Coding Alert
ALJs Move Out of Social Security Administration
PDF
Not all of the items passed in the "Regulatory Reform" section of the newly enacted Medicare law are good for home care providers.
For example, Section 931 of the law requires administrative law judges to move from the Social Security Administration to the Department of Health and Human Services by October 2005. ALJs hear appeals regarding Medicare claims and often reverse contractor determinations.
"Although the law requires steps to be taken to ensure the independence of ALJs after the transition, it is difficult to conclude that the number of positive outcomes for providers will remain the same," says Burtonsville, Md.-based attorney Elizabeth Hogue.
The ALJs have been a "reality check" for Medicare contractors making claims determinations, Sarraille says. Moving them to HHS will undermine the independence that made them a fair avenue for Medicare appeals.
Part B Insider (Multispecialty) Coding Alert
- Evaluation:
Resolution to Stop E/M Code Revisions Goes to Trustees
AMA reconsiders 'clinical examples'
Evaluation and management codes may not move from [...] - History:
Those Who Take a Lousy History Are Condemned to Repent It
4 tips on obtaining a great patient history
It only takes a few minutes for your [...] - Go Beyond The SOAP Note
When taking a history, many doctors are used to obtaining a simple Subjective Objective Assessment [...] - History:
Make Sense of a Single Paragraph
Learn to dissect jumbled history into three categories
Many coders expect the physician to separate notes [...] - History:
Don't Use HPI Info to Satisfy ROS
In a recent set of "frequently asked questions," Part B carrier National Heritage Insurance Co. [...] - Legislation:
Providers Win Regulatory Relief in Medicare Bill
You can correct minor errors without pulling your own teeth
If you're drowning in Medicare paperwork, [...] - ALJs Move Out of Social Security Administration
Not all of the items passed in the "Regulatory Reform" section of the newly enacted [...] - Modifiers:
Bill Separately for Decision to Operate
Understand the difference between modifiers -57 and -25
Before she picks up a scalpel, the surgeon [...] - Physician Notes:
Reform Bill Calls for Twice-Yearly ICD-9 Updates
A provision that nobody noticed beforehand sneaked into the Medicare reform bill signed by President [...]