Denial management is critical to preserving your bottom line.
Coding errors accounted for 8.7 percent of improper payments made by Medicare in 2018, which cost over $2.75 billion. To avoid costly denials and potential payback demands, it’s essential to review code guidelines before submitting your claims.
If
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Due to overwhelming stakeholder feedback — much of it negative — the Centers for Medicare & Medicaid Services (CMS) decided to stagger its overhaul of E/M documentation, coding, and payment policies over the course of two years, with only a handful of revisions for this
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If you shook your head in disbelief at the last round of National Correct Coding Initiative (NCCI) edits, you’re probably not alone. That’s because the Centers for Medicare and Medicaid Services (CMS) created a staggering 45,727 additions, 19,729 deletions, and 41 changes to the list
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Evaluation and management (E/M) services are the bread and butter of most providers’ paychecks. Unfortunately, E/M services are also the most problematic to code, prone to errors related to level of service.
If you’re struggling with a fair share of E/M claim denials, a solid understanding of
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As we prepare to sit down with our families for the holidays and enjoy a day of delicious food and good company, we here at TCI hope that you, too, have a wonderful celebration — not to mention a much-needed break from your CPT® Coding
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Hint: Every service rendered in the global period isn’t necessarily reimbursed in the global package.
Without a clear understanding of Medicare global surgery packages, you could see an influx of claim denials as you unwittingly submit claims for services included in the global package and not
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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
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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
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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
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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
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