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Find Out Which 4 Codes Are Off the DMEPOS 2018 Prior Authorization Master List

18. May 2018

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DMEPOS had a 44 percent improper payment rate according to CERT’s 2017 Medicare FFS report. That’s high. Really high. So anyone submitting claims that fall under DMEPOS needs to be up on all the rules. One important area to watch is Medicare’s Master List of which codes require prior authorization. The recent annual update posted […]

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Podiatry Alert: Here’s What Caused $330 Million in Improper Payments for Part B and DMEPOS

16. April 2018

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We’ve talked about CERT 2017 report results before in this blog, but that’s mostly been Part B. Podiatry coders need to be thinking about DMEPOS, too. And based on the 70.5 percent error rate estimated for podiatry under DMEPOS, practices need to put that on their priority lists. Review the CERT Report Stats The “2017 […]

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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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Emergency Medicine Coders: Don’t Miss These 3 Trending Areas!

28. March 2018

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There have been some hot topics in recent issues of TCI’s Emergency Department Coding & Reimbursement Alert that are just too good not to share. Here’s a quick summary with links to the articles for you lucky readers with access to the online newsletter or to Emergency Medicine Coder. 1. Streamline With This Change to […]

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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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Knock Out 99285 Confusion Now – This ED Code Is Getting Noticed

16. February 2018

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The highest level emergency department code, 99285, is popular. A comparative billing report (CBR) by eGlobalTech recently showed the national percentage of emergency department services submitted with 99285 was 55 percent. And when the highest level E/M code in a group is getting that much use, you know there’s going to be some scrutiny. Here’s […]

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CMS Spring News: Check Out Special Enrollment Periods, QPP Resources, and Quarterly Updates

12. February 2018

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How are you doing this February? I’m looking at some snow, myself. But these three news pieces from CMS show that spring is right around the corner. Don’t miss these deadlines on MIPS suggestions, special enrollment, and HCPCS Q2 implementation. 1. By March 1: Make Your Voice Heard on MIPS If you’ve got suggestions for […]

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3 Smart Ways to Prep for New Medicare Cards

9. February 2018

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To comply with MACRA, CMS is removing social security numbers from Medicare cards. The goal is to help prevent identity theft. Here are three ways you can prepare for this big change. 1. Familiarize Yourself With the New Look The look of the new cards won’t be a drastic change from the old ones. They’re […]

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$36.2 Billion in Improper Payments Means CMS Will Watch These Areas

5. February 2018

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A 90.5 percent accuracy rate for Medicare Fee-for-Service (FFS) payments may not sound too bad, but consider that the 9.5 percent improper payment rate adds up to $36.2 billion! That’s the news from the 2017 Medicare Fee-for-Service Supplemental Improper Payment Data report based on Comprehensive Error Rate Testing (CERT). Smart move: Reviewing CERT results can […]

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