Tag Archive | "Medicare"

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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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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Did You Catch It? New Year, New Look for CLFS

Wednesday, January 17, 2018

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Your 2018 preparations for lab coding aren’t complete if you haven’t looked into the changes to the Clinical Laboratory Fee Schedule (CLFS). Here are some hints from Pathology/Lab Coder to point you in the right direction. Get an Overview of the CLFS Makeover The 2018 CLFS brought a major overhaul to payment for lab testing. […]

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We’ve Wrapped Up 4 Medicare PET Coding and Coverage Resources for You!

Thursday, December 21, 2017

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CMS keeps a close eye on PET imaging, and that means you need to, too. Make sure you’re using all of these resources so you understand coding and coverage for this high-tech imaging option. 1. Know Where to Find NCD Details Medicare has a National Coverage Determination (NCD) for PET scans, with specifics for everything […]

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