Archive | Medicare RSS feed for this section

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

17. January 2018

0 Comments

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. […]

Continue reading...

Improve Your Knowledge of the MIPS Improvement Activities Category

3. January 2018

0 Comments

There’s no time like New Year’s to think about improvement! Improvement activities in MIPS, that is. Background: MIPS focuses on the categories of quality, cost, practice-based improvement activities (IA), and advancing care information (ACI), the last of which focuses on use of certified electronic health record technology (CEHRT). It can be tough to wrap your […]

Continue reading...

Dig In to the IPPS/MS-DRG Alphabet Soup

26. December 2017

0 Comments

Inpatient facility coding and reimbursement come with their own Medicare language, and that includes a fair number of abbreviations. Here’s a beginning glossary to help next time you come across a jumble of letters related to inpatient coding. Hint: The terms are in alphabetical order, but if you’re new to this area, start by reading […]

Continue reading...

We’ve Wrapped Up 4 Medicare PET Coding and Coverage Resources for You!

21. December 2017

0 Comments

CMS keeps a close eye on PET imaging, and that means you need to, too. Make sure you’re using all of these resources so you understand coding and coverage for this high-tech imaging option. 1. Know Where to Find NCD Details Medicare has a National Coverage Determination (NCD) for PET scans, with specifics for everything […]

Continue reading...

Yea or Nay? See Which QPP 2018 Proposals Came Through in the Final Rule

14. December 2017

0 Comments

Back in July, TCI SuperCoder blog had a post about the proposed 2018 Quality Payment Program (QPP) rule, a program established under MACRA. Now that the final rule (with comment period) is out, let’s see how some of those proposals fared. Small Provider Exemption/Low-Volume Threshold Proposal: The proposed rule included adjusting the 2017 low-volume threshold […]

Continue reading...

Medicare Open Enrollment: What’s New for 2018?

14. November 2017

0 Comments

It’s that time of year again — time for your patients to start thinking about their healthcare needs and what they’re looking for in their Medicare health and drug plans. Medicare Open Enrollment began on Oct. 15 and will remain open until Dec. 7. And there’s good news. CMS reports more options and lower premiums […]

Continue reading...

Straight From the Source: Use Modifier 25 the Right Way With CCI Manual Tips

22. September 2017

0 Comments

It can be tricky knowing when to append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service). More specifically it can be tough to determine whether work performed by a provider amounts to a separate […]

Continue reading...

Why HHS Says It’s Focusing on Disenrollment Data in MA Plan Oversight

18. September 2017

1 Comment

Sicker patients seem to be dropping out of some Medicare Advantage (MA) plans, according to a Government Accountability Office (GAO) report from April 2017. Here’s a closer look at the report and the entities involved. A Brief Look at MAs and Their 17.6 Million Beneficiaries CMS contracts with private entities to cover Medicare beneficiaries under […]

Continue reading...