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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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Top Nuances to Know for the Medicare Card MBI Roll-Out

6. August 2018

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Medicare began mailing out new cards in April 2018 to meet the deadline of replacing Social Security numbers/Health Insurance Claim Numbers (HICNs) with Medicare Beneficiary Identifiers (MBIs) by April 2019. Here are some tips you may have missed to help you with the transition. Don’t Use the Dashes! On the new Medicare cards and in […]

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Hot Topic: Get the Scoop on Proposed MPFS 2019 Changes to E/M Coding and Payment

3. August 2018

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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 […]

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Find Out Which 4 Codes Are Off the DMEPOS 2018 Prior Authorization Master List

18. May 2018

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DMEPOS had a 44 percent improper payment rate according to CERT’s 2017 Medicare FFS report. That’s high. Really high. So anyone submitting claims that fall under DMEPOS needs to be up on all the rules. One important area to watch is Medicare’s Master List of which codes require prior authorization. The recent annual update posted […]

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$30 Million in Funding for QPP Measure Development With CMS Cooperative Agreement

12. April 2018

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Have you heard about the CMS program to partner with stakeholders to improve quality measures in the MACRA Quality Payment Program (QPP)? Up to $30 million in funding and assistance is involved over three years. Here Are the Target Groups and Goals A blog post from CMS describes this measure development funding opportunity. Developing, improving, […]

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OIG and CMS Are Both Watching Drug Specimen Validity Testing … Are You?

6. April 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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A Coding Take on World Health Day, April 7

4. April 2018

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The World Health Organization (WHO) uses World Health Day each April to draw attention to global health concerns. Here’s a quick history of recent World Health Day themes with a coding twist. 2018: The theme this year is “Health for All,” with discussion of paths to universal health coverage (UHC) around the world. It is […]

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Turn Back Time With These 2018 MPFS Updates

5. March 2018

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  Keeping up with 2018 updates to the Medicare Physician Fee Schedule (MPFS) is one thing. Knowing which ones are retroactive adds a whole other level to ensuring you’re applying the right information to your claims. Today we’re covering two groups of retroactive MPFS changes. Watch for Work GPCI Floor Increase If you’re in an […]

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