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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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Can We Expect Medicare Audits to Be Friendlier in 2018?

28. February 2018

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No matter how careful you are, Medicare audits happen — and if the thought of an audit is keeping you awake at night, there could be some good news coming your way! This year, the government is supposedly taking a more lenient and educative approach to rectifying Medicare billing errors. Background: For some time now, […]

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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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