Medicare

2019 Physician Fee Schedule and Telehealth

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Virtual Visits, Real Reimbursement: Telehealth and the 2019 Physician Fee Schedule While discussions about the way evaluation and management (E/M) coding could change may have dominated recent coding conversations surrounding the Centers for Medicare and Medicaid Services (CMS) proposed Medicare Physician Fee Schedule (MPFS), other equally Read more..

Posted on 15 Oct, 2018

By Elizabeth
Cardiovascular Care Takes the World’s Stage

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This week is Take Care of You Week - specifically, take care of your heart. We have two back-to-back days commemorating cardiovascular care. Wednesday, September 26th is National Women's Health & Fitness Day, and just three days later, Saturday, September 29th is World Heart Day. Why Read more..

Posted on 26 Sep, 2018

By Elizabeth
Nail Down the Office of Inspector General’s (OIGs) Role

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The Office of Inspector General (OIG) was formed in 1976 by President Gerald Ford through the Inspector General Act. Since then, the OIG has been key in fighting waste, abuse, and fraud in Medicare, Medicaid, and other Health and Human Services programs and is the Read more..

Posted on 11 Sep, 2018

By Elizabeth
Master the 2018 Telemedicine Codes

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Are you up to speed on the 2018 CPT and HCPCS codes for telemedicine, finalized in the Medicare Physician Fee Schedule (MPFS). Read on for an overview of key updates you don’t want to miss. HCPCS codes: G0296 (Counseling visit to discuss need for lung cancer Read more..

Posted on 30 Aug, 2018

By Elizabeth
How to Chart Out the Medical Audit Process

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Medicare determined that a practice had been billing X-rays globally for years, when it should have only billed X-rays with a modifier 26 for the professional interpretation of the service, as the practice didn’t own the X-ray equipment. The fallout of this oversight included an Read more..

Posted on 23 Aug, 2018

By Elizabeth
Conquer Common Documentation Errors Identified by CERT & RAC

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Are you on top of CMS documentation guidelines? The following points identify CMS guidelines for correct documentation that supports and validates the claim submitted for services/procedures: The record of the encounter/episode of care should be complete and legible Documentation should include: Reason for the encounter Assessment, Read more..

Posted on 10 Aug, 2018

By Elizabeth
Conquer Inpatient Telemedicine Consultations

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Inpatient consultations via telemedicine is improving lives. These encounters facilitate the delivery of certain services that might otherwise be unavailable to a patient located at an originating site. While you can’t use telemedicine to provide E/M inpatient encounters, you can use them to substitute for a Read more..

Posted on 27 Jul, 2018

By Elizabeth
Nip Errors in the Bud with the NCCI and MUEs

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Backstory: Why NCCI was Started The Centers for Medicare and Medicaid Services (CMS) is the agency responsible for the implementation of the National Correct Coding Initiative (NCCI), which was developed to encourage correct coding procedures on the national level and to reduce inappropriate coding that Read more..

Posted on 20 Jul, 2018

By Elizabeth
How to Overcome Challenges in Medicine Auditing

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Medicine codes for both therapeutic and diagnostic services include injections, physical medicine, and rehabilitation services. These are some of the most difficult services to audit and, as a result, some of the most frequently audited in the medicine section of CPT®. Injections and infusions Injections and Read more..

Posted on 10 Jul, 2018

By Elizabeth
400% Rise in Healthcare Fraud Takedowns

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National healthcare fraud is on the upswing, with a 400% increase in annual takedowns since 2013—and this, despite sequestration of mandatory funding for the Department of Justice (DOJ), the Department of Health & Human Services (HHS), the Office of Inspector General (OIG), and the FBI. Take Read more..

Posted on 29 Jun, 2018

By Elizabeth

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