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Catch Radiation and Home Visit Changes Coming Soon to Medicare Manual

15. August 2019

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Medicare has announced two updates to the Medicare Claims Processing Manual (MCPM). The implementation date is set for Aug. 27, 2019, but they’re effective all the way back to Jan. 1, 2019. If your physician performs home visits or superficial radiation treatment, you’ll want to be sure your knowledge is up to date. 1. Eliminate […]

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MPFS 2020 Proposed Rule: E/M Blended Payment for 2021 Is Dead

5. August 2019

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Another day, another change to E/M plans for 2021! Medicare has released the 2020 proposed rule for the Medicare Physician Fee Schedule (MPFS), bringing in the recent AMA plan to revise E/M coding in 2021. But what does the MPFS say about Medicare payment for office/outpatient visits in 2021? Here’s the scoop. Know What to […]

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Get a Sneak Peek at CPT® 2020 Additions, Deletions, and Revisions

23. July 2019

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With all the excitement about Medicare and AMA plans for E/M in 2021, don’t forget that the CPT® code set will have changes in 2020, too. The official code set will be out soon, but, in the meantime, here are some hints from the AMA about the changes you’ll have to know for Jan. 1. […]

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Smash 3 Myths to Upgrade Your Mammography Coding and Coverage Knowledge

18. July 2019

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Mammography is a common service, but radiology coders need to learn some not-so-common rules. Take your know-how to the next level by getting to the truth about these myths. Myth 1: Mammography Is for Women Only Medicare’s National Coverage Determination (NCD) for Mammograms states that “diagnostic mammography is a radiologic procedure furnished to a man […]

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CCI Modifiers: July 1 Update to Modifier 59 Rule Is Now in Force … and More

16. July 2019

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Modifiers are the key to overriding Correct Coding Initiative (CCI) edits, so let’s give them the attention they deserve. We’ll start with a recent rule update and move on to helpful hints about CCI-associated modifiers in general. Which CCI edits? Our focus here will be Medicare CCI Procedure-to-Procedure (PTP) edits for physicians and practitioners. Do […]

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Modifier 51 Hints: Your Go-To Guide for the MPFS Multiple Procedure Column

13. June 2019

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There are nine different Multiple Procedure indicators on the Medicare Physician Fee Schedule (MPFS), meaning there are a lot of payment adjustment possibilities you need to know. Here’s each indicator, an example of a code with that indicator, and a quick look at where modifier 51 comes into play. What Is Modifier 51? The basic […]

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Modifier 25 Scavenger Hunt! Can You Find These Answers?

21. May 2019

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Keeping up with modifier 25 rules can be intimidating, so let’s add a little fun by seeing if you can unearth the answers to these questions at the locations provided. Ready, set, go! 1. Is This a Separate E/M? You may have the descriptor memorized for modifier 25 (Significant, separately identifiable evaluation and management service […]

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Bulk Up Your Global Surgical Package Knowledge for Cleaner Claims

6. May 2019

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Let’s take Medicare’s list of services included in global surgery payment up a notch. If you remember each added tip below, you’ll be more likely to avoid reporting both too many and too few codes. Read This Booklet to Dive Deeper The source of the straight-from-Medicare bullet points quoted below is Medicare’s Global Surgery Booklet. […]

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Medicare Helper: Don’t Let DOS Be the Downfall for Your Claims

2. May 2019

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Determining date of service (DOS) can be harder than it seems. Once you dive into the world of professional/technical components, monitoring services, and other non-obvious DOS possibilities, things get complicated fast. You can use the Medicare rules below as a starting point. Apply Different Dates for Radiology Components For many radiology codes, the Medicare Physician […]

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Tick-Tock: Understand Why Time Matters for E/M Coding

22. April 2019

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For E/M, there has been a lot of attention on how the role of time will change in 2021. But what about right now? After this skill sharpener on time in the AMA CPT® E/M guidelines, you’ll have a better understanding of time’s current role in E/M coding. Where to Find AMA CPT® E/M Guidelines […]

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