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Cataract Claims Double Dipped? These RACs Are Checking

8. June 2018

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If you perform cataract removal services in RAC regions 1, 2, or 3, be on alert. Coding and unit errors are under the spotlight. Here’s the scoop. What & Where: Learn the RACs and Regions Involved RACs Cotiviti Healthcare and Performant have both posted the following as approved audit issues: 0083 – Cataract Removal Excessive […]

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Prep Time! July 2018 MPFS Updates Bring More Than RVU Changes

1. June 2018

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We’re a month away from the July 2018 Medicare Physician Fee Schedule (MPFS) update. These quarterly changes are easy to overlook, but checking any fee schedule update is important. Even if, for some reason, you’re not interested in RVU changes, there may be changes to indicators (like PC/TC) that affect proper reporting. Here are some […]

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3 ICD-10-CM Cardiology Coding Tips That Line Up With the Risk-Adjustment Trend

25. May 2018

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All the discussions of risk adjustment have put a spotlight on diagnosis coding, and one big way cardiology coders can help is by ensuring they follow the official rules for coding and learn about coding comorbidities, too. Here are some good, old-fashioned rules that will also help ensure your pro-fee cardiology coding follows best practices […]

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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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Will ICD-11 Have a Code for ‘Struck by Turtle’?

3. May 2018

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Subcategory W59.22- (Struck by turtle) is an ICD-10-CM code that’s been in the blog a few times. So when I started playing with the WHO ICD-11 Coding Tool, I had to try “turtle” as a search term. No luck, but I did find PA71 (Unintentionally struck, kicked, or bumped by animal) after I changed my […]

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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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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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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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