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Get 1 Step Closer to 99285 Perfection With This HPI Primer

26. April 2018

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Emergency medicine code 99285 seems to be popping up a lot lately because of potential overuse. To help give you your best chance at coding correctly, it helps to take a close look at each element involved. Today, let’s look at the history of present illness (HPI) requirement. The good news is that most of […]

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Compare 38571-38573 Lymphadenectomy Codes At-a-Glance to Avoid Cutting Reimbursement in Half

20. April 2018

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If you’re already familiar with laparoscopic bilateral total pelvic lymphadenectomy codes 38571 and 38572, you know the pattern. The second code descriptor builds on the first. When the CPT® 2018 code set added 38573, the new code descriptor followed that pattern, adding quite a few more requirements before you use the new code. Not sure […]

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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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$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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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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Know When CCI Manual Says to Use Bone Marrow Code 38222

19. March 2018

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The addition of diagnostic bone marrow and biopsy code 38222 in the CPT® 2018 code set simplified coding in some ways (multiple procedures in one code), but there are still questions to be answered about how to handle specific scenarios. In case you missed it, the 2018 Correct Coding Initiative (CCI) manual answered some of […]

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Understand Screening vs. Diagnostic With This Mammography Coding Snapshot

12. March 2018

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When the CPT® 2017 code set introduced 77065-77067 for mammography, CMS hung on to HCPCS options G0202, G0204, and G0206 a while longer. But now Medicare accepts the CPT® codes, and the HCPCS options have been sent to the discontinued-code pile. Here’s helpful information on screening vs. diagnostic mammography to help you use the CPT® […]

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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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