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Pop Quiz: Test Your Assumptions About QPP 2019 Payment Year

10. December 2018

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Understanding the Medicare Quality Payment Program (QPP) is tough. But the data Medicare released from the 2017 performance year shows you were up for the challenge. And that’s good news because the 2017 performance year affects 2019 Medicare payments and maybe has helped you prepare for the 2019 performance year, too. Let’s see how you […]

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Language Lesson: Add These Terms to Your MIPS 2019 Glossary to Save Research Time

4. December 2018

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When MACRA and MIPS come up, does it feel like speaking another language? For the 2019 performance year, there are even some new terms to learn. We’ve got the new language and tips on where you’ll see it used so you don’t have to spend time searching. Collection Type: Apply to Sets of Similar Quality […]

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Drum Roll: What Does MPFS 2019 Final Rule Say About E/M?

5. November 2018

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Medicare released the CY 2019 Medicare Physician Fee Schedule (MPFS). One of the big questions from the proposed rule was whether E/M payment rules would change. Here are some highlights on what made it into the final rule for E/M and what didn’t. The News You’ve Been Waiting for … The proposal to combine payment […]

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Know 3 Rule-Out Rules for Better ICD-10-CM Coding

25. October 2018

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If you come across documentation that refers to ruling out a diagnosis, it’s time to go on high alert. There are some specific rules you need to follow for ICD-10-CM coding. Here are tips straight from the 2019 ICD-10-CM Official Guidelines for Coding and Reporting (OGs). 1. Know When to Use Codes That Specify ‘Ruled […]

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Smart Move: Know These Top Medicare Denial Reasons AND How to Avoid Them

10. October 2018

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  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 […]

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Do You Know the Answers to These Medicare Disaster Relief Questions?

3. October 2018

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Because of Hurricane Florence, CMS issued several waivers in North Carolina, South Carolina, and Virginia to help with access to healthcare. Even if you’re not in an affected area, this should be a reminder that disaster prep isn’t just about working in theory. You need to understand it well enough to apply it. Below you’ll […]

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2019 MPFS: Prolonged Preventive Service Codes May Make It On to Telehealth List

25. September 2018

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If telehealth is on your radar, you’ll want to watch the Medicare Physician Fee Schedule for 2019. The MPFS 2019 proposed rule discusses potential changes to Medicare telehealth services, specifically the addition of G0513 and G0514 to the Medicare telehealth list. Get a closer look at these codes so you’ll better understand them and the […]

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Provider Change Practice? Understand 2019 Payments for MIPS 2017 Performance Year

4. September 2018

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With 2018 being in its last half, questions are coming up about MIPS payment adjustments in 2019 based on the 2017 performance year. One topic of interest is what happens if a clinician moved from one practice to another. Here is an answer, straight from the CMS Fact Sheet on 2019 MIPS payment adjustments based […]

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Modifier 58 or 78? Master These Confusing Modifiers

13. August 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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Crash Course: Compare ICD-10-CM 2019 Official Guidelines for Post-Op Sepsis to 2018 Rules

9. August 2018

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The ICD-10-CM 2019 Official Guidelines are out and offer more details on how to use new codes for sepsis following a procedure. Take a look at what’s new and get a handle on how to sequence these codes. Remember These New Codes to Improve Sepsis Coding ICD-10-CM 2019 includes these two new codes with instructional […]

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