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Don’t Get Too Comfortable With That Meaningful Use Payment – Here’s Why

20. June 2017

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When the title of an OIG report is about Medicare paying out hundreds of millions it shouldn’t have, that’s not great news for Medicare or the providers who got those funds. But that’s exactly what a report released June 12, 2017, says: “Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did […]

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3 Things You Can Do Today to Prepare for a RAC Audit

7. June 2017

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What’s the first think you think of when you hear Recovery Audit Contractor? RACs have been around for a while (and not without controversy) as part of a Medicare program to find and correct past improper payments. Even folks who don’t get nervous at the thought of an audit probably don’t look forward to the […]

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Step-by-Step Guide to Checking National Correct Coding Initiative Edits on SuperCoder

6. June 2017

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CCI Edits Checker is one of the tools SuperCoder subscribers use the most, so here’s a quick instructional guide to help users make the most of this resource, including the color-coded results and RVU options.   Note: This guide is specific to the CCI Edits Checker for Medicare PTP practitioner edits, but Outpatient Facility Coder […]

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Here’s What’s in Store for Medicare Advantage and Part D in 2018

23. May 2017

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Check out these bullet points for highlights from the 2018 Medicare Advantage and Part D payment and policy updates posted by CMS. Medicare Advantage Medicare Advantage (MA) plans, sometimes called Medicare Part C, are private plans approved by Medicare for people enrolled in Medicare. Medicare pays a fixed amount to the MA plan company, and […]

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4 Motivators for Sticking to the Coding Straight and Narrow

8. May 2017

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If you ever take the “throw everything out there and see what sticks” approach to coding, it’s time to rethink that strategy. Carefully choosing the wrong codes to bring in more money is no way to code either. Next time you need inspiration to steer clear of these methods, reach for these four reasons coding […]

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Secrets to Subsequent Hospital E/M Coding Success

2. May 2017

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Curious how your use of subsequent hospital visit codes compares to reporting by other practices? Palmetto was curious, too. The Part B MAC took part in developing a Comparative Billing Report (CBR) looking at 99231-99233 billing and payment patterns in 2015 for internal medicine providers. Motivation? Those codes see about a billion dollars in improper […]

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2 Costly Hip Coding Mistakes Corrected

18. April 2017

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With all the hippity hoppity talk this time of year, I have coding for hips on the brain. Might as well go with it and look into some hip coding tips! 1. Watch for Mod 22 Opportunities With Congenital Cases If your surgeon performs hip replacement surgery for a developmental or congenital hip dislocation, there’s […]

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60 Days & 6 Years: The Numbers to Know to Comply With Medicare’s Overpayment Rule

4. April 2017

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You get a fairly clear picture of what this rule is about from its name: Medicare Reporting and Returning of Self-Identified Overpayments. If you discover Medicare gave you too much money, you have to give it back. But there are some layers here, so let’s dig in for a refresher on some of the more […]

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Here’s What’s New in Q2 for CCI, MPFS, and HCPCS

27. March 2017

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It’s almost April! In addition to a potential end to the yellow pine pollen covering every surface outside my home (yours, too?), April means second quarter updates to Correct Coding Initiative (CCI) edits, fee schedules, and HCPCS. Ready for some highlights? Let’s go! CCI for Moderate Sedation Goes Retro If you read this blog regularly, […]

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Get a Glimpse at Potential 2018 MACRA Coding Requirement for Patient Relationship Category

3. March 2017

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There could be new HCPCS modifiers coming your way as part of MACRA to identify patient relationship categories. If the term “patient relationship categories” is new to you, then here’s a brief overview. MACRA requires patient relationship categories and codes as part of an effort to improve resource attribution to clinicians. So there’s a look […]

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