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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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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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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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Improve Your Knowledge of the MIPS Improvement Activities Category

3. January 2018

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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 […]

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Dig In to the IPPS/MS-DRG Alphabet Soup

26. December 2017

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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 […]

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

21. December 2017

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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 […]

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

14. December 2017

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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 […]

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