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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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$30 Million in Funding for QPP Measure Development With CMS Cooperative Agreement

12. April 2018

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Have you heard about the CMS program to partner with stakeholders to improve quality measures in the MACRA Quality Payment Program (QPP)? Up to $30 million in funding and assistance is involved over three years. Here Are the Target Groups and Goals A blog post from CMS describes this measure development funding opportunity. Developing, improving, […]

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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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A Coding Take on World Health Day, April 7

4. April 2018

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The World Health Organization (WHO) uses World Health Day each April to draw attention to global health concerns. Here’s a quick history of recent World Health Day themes with a coding twist. 2018: The theme this year is “Health for All,” with discussion of paths to universal health coverage (UHC) around the world. It is […]

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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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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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CMS Says No to Texting Orders (What Emoji Would That Be, Anyway?)

31. January 2018

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If providers want official proof they shouldn’t be texting orders, direct them to a recent memo from CMS, “Texting of Patient Information Among Healthcare Providers.” Memo summary: Nope. Just don’t do it. Don’t text orders. And if you’re going to text other members of the healthcare team about patients, keep security in mind. Here’s Why […]

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7 Achievable New Year’s Resolutions For Healthier Coding & Reimbursement in 2018

25. January 2018

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Did You Catch It? New Year, New Look for CLFS

17. January 2018

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Your 2018 preparations for lab coding aren’t complete if you haven’t looked into the changes to the Clinical Laboratory Fee Schedule (CLFS). Here are some hints from Pathology/Lab Coder to point you in the right direction. Get an Overview of the CLFS Makeover The 2018 CLFS brought a major overhaul to payment for lab testing. […]

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