Part B Insider (Multispecialty) Coding Alert
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Obtaining the Medicare payments that are rightfully yours may get even tougher if one influential lawmaker gets his way. In an Oct. 6 letter to Health and Human Services Secretary Kathleen Sebelius and CMS Administrator Donald Berwick, Senate Finance Committee Ranking Member Charles Grassley (R-Iowa) asks CMS to hold its Medicare contractors more accountable for overpayments due to fraud and abuse. Grassley cites billing from DME fraudsters as an example of the losses for which Medicare contractors should be held accountable. He also highlights the OIG's latest series of reports on DME claims using KX modifiers, in which the OIG detected overpayments. Grassley is concerned about "the lack of or inadequate management and oversight of contractors by" CMS, he says in the letter.
Part B Insider (Multispecialty) Coding Alert
- E-Prescribing:
Carriers Only Accept G8553 for E-Prescribing in 2010, CMS Reminds Practices
Using the 2009 e-prescribing G codes will lead you to face claims rejection, CMS reps [...] - Diagnosis Coding:
Think 'Likely' Diagnosis Trumps Symptoms? Think Again
Look for these phrases in your physician's documentation.Typically, your first-listed ICD-9 code is your physician's [...] - Part B Revenue Booster:
Boost Your Bottom Line With These 3 E/M Documentation Steps
Tip: Don't miss the endocrine system when you're tallying ROSOne missed documentation element could mean [...] - Billing:
Use This Advice to Avoid Patient Run-Ins When Collecting Deductibles
Navigate your way when carriers give you conflicting advice about deductibles, but use business sense [...] - Reader Questions:
Hernia Terminology Key to Code Selection
Question: What is the difference between umbilical hernia and ventral hernia? What do I need [...] - Reader Questions:
Add Modifier 24 For Treatment Discussion During Global
Question: A patient came in for the biopsy report after a 90-day global procedure. The [...] - Reader Questions:
93015 Plus E/M May Equal Denial
Question: May I report an E/M service in addition to a stress test?Answer: The answer [...] - Reader Questions:
99211 May Apply to Med Check
Question: The physician started an established patient on a new drug. Two weeks later, the [...] - Physician Notes:
Nearly Half of Medical Students Are Trained in Fraud and Abuse Prevention
Plus: Senator Wants Medicare Contractors To Get ToughCoders often wonder why medical schools don't better [...] - In other news:
Obtaining the Medicare payments that are rightfully yours may get even tougher if one influential [...]