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 […]
Continue reading...6. December 2018
For the 2019 Medicare Physician Fee Schedule (MPFS), we’ve talked about E/M and a bit about remote monitoring. But now let’s take a general overview of the ups and downs expected for individual specialties. Know Where to Find the Info and What It Means Table 94 of the 2019 MPFS final rule is titled “CY […]
Continue reading...13. November 2018
Filing third-party claims is a big part of the business of medicine, but collecting payment from patients is also crucial to a healthy organization. There are challenges, though. Check out these tips on steering clear of problems and on handling those issues that do come up. 1. Have a Policy and Let Patients Know You […]
Continue reading...10. October 2018
Let’s put data to work to help prevent denials! CGS is one of the Medicare contractors that provides information on top claim denial reasons, and here we’ll take a look at some denial triggers from August 2018 and how you can prevent them. Check Status Before Reporting Duplicate Service Reporting the exact same service […]
Continue reading...3. August 2018
The 2019 proposed Medicare Physician Fee Schedule (MPFS) includes some major potential changes to E/M coding and payment in its 665 pages. Major. Here are the highlights. Just remember that what’s below is proposed and may change before the final rule is implemented. Here’s the Big Payment News About Levels 2-5 Let’s get right to […]
Continue reading...16. March 2018
Curious about the world of chargemasters? These three questions will give you a speedy introduction to this crucial revenue cycle management tool used by hospitals. 1. What Is a Chargemaster? A hospital chargemaster, also called a hospital charge description master, lists the billable services and items that a hospital provides to patients. Some of the […]
Continue reading...8. February 2018
A lot of the talk around TCI SuperCoder lately has been focused on our recently improved 2018 Data Files and the major financial consequences that can result from an organization’s choice of data files. Why is this choice so important? When it comes to medical codes, data sets have to have the right information in […]
Continue reading...17. January 2018
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. […]
Continue reading...4. April 2017
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 […]
Continue reading...1. November 2016
CPT® provides a surprising number of options for coding tubal ligations, informally known as a patient having her tubes tied. I’ve pulled three tips from one of our more popular Ob-Gyn Coding Alert articles that provide some expert insights into getting these claims right, focusing on some areas you may not have considered. Helpful hint: […]
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24. January 2019
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