Medicare

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    Your new 2019 CPT® manual contains a lot of changes to the peripherally inserted central venous catheter (PICC) codes and guidelines. But if you code for a provider who has received PICC certification, you don’t have to get overwhelmed. We’ve added up all the major 2019   Read more..
    Posted on 12 Dec, 2018
    2019 CPT® PICC Code Updates by the Numbers
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    SPOILER ALERT: More shake ups, reductions, and rebalancing for 2019. The Centers for Medicare & Medicaid Services (CMS) released revisions to payment policies under the Medicare Physician Fee Schedule (MPFS) for the Quality Payment Program (QPP) for calendar year 2019. “The Year 3 policies are reflective of the   Read more..
    Posted on 7 Dec, 2018
    What You Need to Know About the Quality Payment Program, Year 3
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    If you’ve read TCI’s Medicare Compliance and Reimbursement Insider, then you already know the painful truth: If your practice receives Medicare reimbursement for services rendered to Medicare beneficiaries, and if you cannot prove medical necessity for those services, then you can be prosecuted under the   Read more..
    Posted on 4 Dec, 2018
    4 Things You Need to Know about Medical Necessity, Fraud, and the False Claims Act
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    To file claims for reimbursement to Medicare, you must be a recognized Medicare provider or supplier, meaning that you must first enroll in Medicare. CMS gives you two enrollment options: You can take the paper route and fill out and submit by mail the CMS-855   Read more..
    Posted on 30 Nov, 2018
    Navigating Medicare’s Provider Enrollment, Chain, and Ownership System (PECOS)
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    CMS has just released its Final Rule on the 2019 Medicare Physician Fee Schedule, and for the moment the dust has settled on all the discussions, debates, and deliberations regarding evaluation and management (E/M) levels and documentation. It contains a picture – albeit one that   Read more..
    Posted on 12 Nov, 2018
    5 Big Takeaways From the 2019 MPFS Final Rule
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    If you routinely document evaluation and management (E/M) services, you’ve probably been waiting anxiously since July for the Centers for Medicare and Medicaid Services (CMS) to release the 2019 Medicare Physician Fee Schedule Final Rule to see if the proposed changes to the E/M guidelines will be enacted   Read more..
    Posted on 1 Nov, 2018
    Levelling the E/M Playing Field: CMS Proposes Solution to Guideline Confusion
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    In part one of this series, we looked at several new 2019 CPT® codes that will enable you to capture payment for telehealth services. In this second blog, we’re going to look at another way telehealth is reshaping healthcare by changing the way providers monitor   Read more..
    Posted on 29 Oct, 2018
    The RPM Revolution Begins!
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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
    2019 Physician Fee Schedule and Telehealth
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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
    Cardiovascular Care Takes the World’s Stage
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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
    Nail Down the Office of Inspector General’s (OIGs) Role

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