Author Archives | deborahm

deborahm - who has written 239 posts on SuperCoder Blog.

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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Bring in Correct Bilateral Procedure Pay With These Pro Pointers

Thursday, February 7, 2019

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Choosing medical codes and modifiers for bilateral services can be confusing. Here are a few questions you can ask to help ensure accurate coding and reimbursement for physician claims. Does the Code Descriptor Specify Bilateral? “Bilateral surgeries are procedures performed on both sides of the body during the same operative session or on the same […]

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Update Your Knowledge of MIPS Promoting Interoperability for 2019

Monday, February 4, 2019

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In 2019, there are some changes to the Promoting Interoperability performance category of MIPS. Here’s what you need to know about CEHRT and scoring news for this performance year. Background: MACRA requires the Quality Payment Program (QPP) to include a MIPS performance category on meaningful use of certified EHR technology, the QPP 2019 rule states. […]

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Primary Care and Specialists Need to Know These Twin Add-On Codes by 2021

Monday, January 28, 2019

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The 2019 MPFS proposed rule discussed potential add-on G codes to represent E/M visit complexity. Here’s a quick look at the intent of the proposed codes and what the final rule had to say about their implementation in 2021. See What Happens to This Code for Specialists In the 2019 Medicare Physician Fee Schedule (MPFS) […]

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Here’s How Medical Documentation Can Help or Hurt for Reimbursement

Thursday, January 24, 2019

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The 2018 CERT report estimates 58 percent of Medicare improper payments were caused by insufficient documentation (and this is an ongoing trend). More than half is nothing to sneeze at, especially when you consider that those documentation problems could lead to having to repay Medicare or having to spend time working on underpayments. Here’s a […]

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Outpatient Coders: Are These C Codes on Your Procedure Reporting List?

Tuesday, January 22, 2019

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The HCPCS 2019 code set features several new C codes related to reporting procedures. If you use C codes, make sure you’ve got these updates on your radar. Reminder: HCPCS C codes are intended for use by Outpatient Prospective Payment System (OPPS) hospitals. The codes are used to report device categories, new technology procedures, and […]

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Say Cheese! Medicare Is Paying for Photo and Video Evals in 2019

Thursday, January 17, 2019

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If a picture is worth 1,000 words, how much is evaluating a picture worth? Medicare has taken a stance on that. As of Jan. 1, 2019, Medicare is paying for remote evaluation of pre-recorded patient videos and images reported using G2010. Here’s what we know from the Medicare Physician Fee Schedule Final Rule. Compare Our […]

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Take the Mystery Out of the MPFS Conversion Factor and Calculations

Monday, January 14, 2019

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In the 2019 Medicare Physician Fee Schedule (MPFS), the conversion factor is 36.0391 compared to 35.9996 in 2018. But that sort of information helps only if you know what a conversion factor is and what to do with it. Here’s a primer you can turn to when you need to brush up on your MPFS […]

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Here’s How MIPS Participation Eligibility Shrinks and Grows in 2019

Thursday, January 10, 2019

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We’re in the third year of the Quality Payment Program (QPP), which includes the Merit-based Incentive Payment System (MIPS). The QPP is connected to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Because MIPS may result in Medicare payment adjustments up or down, knowing whether you’re required to participate is an essential first […]

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Modifier 59 Misuse Cost 1 Health System Millions — Know Where to Go for the Rules

Monday, January 7, 2019

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Exploiting modifier 59 was a major factor in a recent $12.5 million settlement for False Claims Act allegations. How’s that for motivation to shore up your modifier 59 know-how? Here are some resources to get you on your way. Read the Write-Up on the Recent False Claims Act Settlement Find out some of the details […]

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HCPCS 2019: Update CROS/BiCROS Hearing Device Codes for a Better Clinical Match

Friday, January 4, 2019

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For those of you who report contralateral routing hearing aid devices (CROS/BiCROS), here’s what you need to know about the big makeover these codes got for 2019. Catch the Little Differences in Code Descriptors As noted in a previous blog post about HCPCS 2019, the hearing aid codes will test your ability to spot tiny […]

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