Tag Archive | "cms"

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

Friday, April 20, 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

Monday, April 16, 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

Thursday, April 12, 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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CMS Spring News: Check Out Special Enrollment Periods, QPP Resources, and Quarterly Updates

Monday, February 12, 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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CMS Says No to Texting Orders (What Emoji Would That Be, Anyway?)

Wednesday, January 31, 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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Stay Sharp! Here’s Why ‘ICD-10 Specificity Fatigue’ Can Get You in Trouble

Friday, July 29, 2016

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After years on the ICD-10 prep treadmill, your mind may go numb when you hear “ICD-10 specificity requirements” repeated for the millionth time. Wake up call: CMS has a couple of upcoming changes that will add some new energy to your clinical documentation improvement and ICD-10 code choice efforts. Oct. 1: Denials May Increase When […]

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Adjust to Modifier JW Change by January (Not July)

Thursday, June 16, 2016

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For years, Medicare has had a rule that lets local MACs decide whether their providers have to use modifier JW (Drug amount discarded/not administered to any patient). All that is about to change. Effective Jan. 1, 2017, Medicare will require modifier JW use by all providers for discarded Part B drugs and biologicals. The implementation […]

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Details of CMS’s ICD-10 “Family” Business

Thursday, September 10, 2015

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Curious about CMS’s guidelines regarding code families? The CMS-AMA compromise this summer included the agreement that for one year, CMS will not deny Medicare claims based on ICD-10 specificity as long as you report valid ICD-10 codes from the correct “family.” The term “family of codes” refers to the same thing as an ICD-10 three-character […]

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