Tag Archive | "Medicare"

Modifier 58 or 78? Master These Confusing Modifiers

Monday, August 13, 2018

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Knowing when to use modifiers 58 and 78 isn’t easy. Base your choices on this straight-from-Medicare guidance to help ensure cleaner claims. Make Modifier 58 Your Choice for Anticipated Procedures Modifier 58 (Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period) is the focus […]

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Top Nuances to Know for the Medicare Card MBI Roll-Out

Monday, August 6, 2018

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Medicare began mailing out new cards in April 2018 to meet the deadline of replacing Social Security numbers/Health Insurance Claim Numbers (HICNs) with Medicare Beneficiary Identifiers (MBIs) by April 2019. Here are some tips you may have missed to help you with the transition. Don’t Use the Dashes! On the new Medicare cards and in […]

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3 Things to Know About Advanced Practice Providers in Your Practice

Friday, July 20, 2018

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Advanced practice providers (APPs), sometimes known as non-physician practitioners (NPPs), are essential members of the healthcare team and serve a lot of roles. But, of course, “essential” doesn’t mean they’re always easy to code for. Make sure you keep these top pointers in mind when you’re completing claims for APPs, such as physician assistants, certified […]

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

Friday, June 1, 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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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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OIG and CMS Are Both Watching Drug Specimen Validity Testing … Are You?

Friday, April 6, 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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Move Over Q1 MUEs … April 1 Changes Are Coming

Thursday, March 1, 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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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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3 Smart Ways to Prep for New Medicare Cards

Friday, February 9, 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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$36.2 Billion in Improper Payments Means CMS Will Watch These Areas

Monday, February 5, 2018

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A 90.5 percent accuracy rate for Medicare Fee-for-Service (FFS) payments may not sound too bad, but consider that the 9.5 percent improper payment rate adds up to $36.2 billion! That’s the news from the 2017 Medicare Fee-for-Service Supplemental Improper Payment Data report based on Comprehensive Error Rate Testing (CERT). Smart move: Reviewing CERT results can […]

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