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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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Ins and Outs of Increasing Revenue for Your Orthopedic Practice

28. December 2017

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The 2018 update season has brought some interesting news for orthopedics, from staggering numbers of ICD-10-CM changes to removing TKA code 27447 from the inpatient-only list. The changes are a good reminder (as if you needed one) that there are a lot of factors involved in keeping an orthopedic practice financially sound. Here are some […]

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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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5 Fast Facts About 1 Payer’s 50 Percent Fee Reduction for Modifier 25

6. November 2017

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A payer’s big modifier 25 payment reduction has been getting a lot of attention, both from providers affected and those concerned other payers will adopt the policy. Don’t miss this overview of what the policy is all about. 1. Which Payer Implemented the Policy? Independence Blue Cross, which primarily serves Philadelphia and southeastern Pennsylvania, updated […]

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Will You Benefit From These MPFS Quarterly Update Changes?

8. September 2017

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Keeping up with quarterly Medicare Physician Fee Schedule updates can be tough. One reason is that sometimes the changes are implemented on one date and effective in the past. Confused? Examples can help with that. The changes below have an implementation date of Monday, Oct. 2, 2017, as part of the October quarterly MPFS update. […]

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Don’t Get Too Comfortable With That Meaningful Use Payment – Here’s Why

20. June 2017

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When the title of an OIG report is about Medicare paying out hundreds of millions it shouldn’t have, that’s not great news for Medicare or the providers who got those funds. But that’s exactly what a report released June 12, 2017, says: “Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did […]

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3 Things You Can Do Today to Prepare for a RAC Audit

7. June 2017

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What’s the first think you think of when you hear Recovery Audit Contractor? RACs have been around for a while (and not without controversy) as part of a Medicare program to find and correct past improper payments. Even folks who don’t get nervous at the thought of an audit probably don’t look forward to the […]

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60 Days & 6 Years: The Numbers to Know to Comply With Medicare’s Overpayment Rule

4. April 2017

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You get a fairly clear picture of what this rule is about from its name: Medicare Reporting and Returning of Self-Identified Overpayments. If you discover Medicare gave you too much money, you have to give it back. But there are some layers here, so let’s dig in for a refresher on some of the more […]

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Haven’t Started MACRA QPP Prep? There’s Still Time!

3. February 2017

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Groundhog Day has come and gone, and Punxsutawney Phil has declared six more weeks of winter. That gives you plenty of inside time to focus on getting up to speed on MACRA so you can participate in 2017. Remember: With CMS’s Pick Your Pace approach to the Merit-based Incentive Payment System (MIPS), it’s OK if […]

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CCI Errors: Some Moderate Sedation Pay May Be Delayed Until April

27. January 2017

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  Seeing the new 2017 moderate sedation codes appear among the 99,490 new National Correct Coding Initiative (NCCI or CCI) edits wasn’t really a surprise, but a handful of those edits just might cause you some headaches all the same. The culprit? Modifier indicators. The good news? There should be a correction in the next […]

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