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Compare 38571-38573 Lymphadenectomy Codes At-a-Glance to Avoid Cutting Reimbursement in Half

20. April 2018

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If you’re already familiar with laparoscopic bilateral total pelvic lymphadenectomy codes 38571 and 38572, you know the pattern. The second code descriptor builds on the first. When the CPT® 2018 code set added 38573, the new code descriptor followed that pattern, adding quite a few more requirements before you use the new code. Not sure […]

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OIG and CMS Are Both Watching Drug Specimen Validity Testing … Are You?

6. April 2018

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Coding for drug testing and specimen validity testing was the focus of recently released MLN Matters SE18001. At the end of the MLN article, there’s a link to an OIG report on the topic revealing millions in improper payments. If CMS and the OIG consider something you code worthy of focus, you really should read […]

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How to Avoid a $233 Vulvectomy Coding Mistake

30. March 2018

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Not sure whether to report an integumentary or vulvectomy code when your ob-gyn treats a patient for a vulvar lesion? If you select the wrong code, your practice could lose out on the money it rightfully deserves. Did you know? Vulvectomies involve much more work and therefore have higher RVUs than lesion excisions. For instance, […]

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Don’t Miss a Single Cognitive Care Planning Code 99483 Requirement! Take Them One at a Time

23. March 2018

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One of the most significant changes for family medicine in 2018 is the switch from HCPCS to CPT® for behavioral health integration (BHI) and care management. In this post, we’ll check out new cognitive assessment code 99483, which not only replaced G0505, but also added 160 words to the descriptor! Walk Through the New Code […]

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Get Ready! CMS Is Introducing More Specific Pricing Modifiers for Oxygen Flow Rate

22. March 2018

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CMS plans to revise and introduce new pricing modifiers for oxygen flow rate. So if you submit claims for oxygen services, make sure you and your billing staff members are aware of these changes effective April 1, 2018. Here’s a heads-up! Why the Change? Medicare has taken this step as the existing modifiers do not […]

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Know When CCI Manual Says to Use Bone Marrow Code 38222

19. March 2018

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The addition of diagnostic bone marrow and biopsy code 38222 in the CPT® 2018 code set simplified coding in some ways (multiple procedures in one code), but there are still questions to be answered about how to handle specific scenarios. In case you missed it, the 2018 Correct Coding Initiative (CCI) manual answered some of […]

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Understand Screening vs. Diagnostic With This Mammography Coding Snapshot

12. March 2018

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When the CPT® 2017 code set introduced 77065-77067 for mammography, CMS hung on to HCPCS options G0202, G0204, and G0206 a while longer. But now Medicare accepts the CPT® codes, and the HCPCS options have been sent to the discontinued-code pile. Here’s helpful information on screening vs. diagnostic mammography to help you use the CPT® […]

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Turn Back Time With These 2018 MPFS Updates

5. March 2018

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  Keeping up with 2018 updates to the Medicare Physician Fee Schedule (MPFS) is one thing. Knowing which ones are retroactive adds a whole other level to ensuring you’re applying the right information to your claims. Today we’re covering two groups of retroactive MPFS changes. Watch for Work GPCI Floor Increase If you’re in an […]

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Move Over Q1 MUEs … April 1 Changes Are Coming

1. March 2018

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  Hey, early birds. Have you checked out the Q2 updates to Medically Unlikely Edits (MUEs)? CMS provides spreadsheets showing quarterly updates so you can see the changes and start preparing ahead of time. Here are some highlights from the changes effective April 1, 2018, to existing practitioner MUE values, along with some tips on […]

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Complete This Scavenger Hunt to Rule Path/Lab in 2018

26. February 2018

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Every medical specialty has its coding nuances, but pathology and lab coding has to rank near the top when it comes to specialized rules. And just when you thought you’d mastered them all, 2018 came along to add more for you to learn. Ready to test your skills? Below you’ll find a scavenger hunt of […]

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