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Watch April MPFS Update for NGACO Code Changes With a January Twist

18. March 2019

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Ready for some retroactive MPFS changes? The next Medicare Physician Fee Schedule update may have an April 1, 2019, implementation date, but the effective date is Jan. 1, 2019. The theme for the HCPCS codes involved is Next Generation Accountable Care Organization (NGACO) Model Post Discharge Home Visits. Remember: “MACs will not search their files […]

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Keep Your Finger on the OIG Pulse by Knowing Where to Find Audit Targets

12. March 2019

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OIG audit targets can feel like moving targets with the website updated each month. Find out where you can go to keep tabs on the Office of Inspector General’s Work Plan items, and see an example of a recently added area to watch. (Tip: For more OIG information, you also can check out this free […]

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6 Ways to Put Medical Office Biller to Work for You

11. March 2019

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Sifting through all the options for online coding and billing software can be a slog, so we put together an at-a-glance breakdown of the top points you need to know for Medical Office Biller! You may have expected MPFS tools, but did you know you get coding Survival Guides and a monthly practice management newsletter […]

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Look Ahead to These 3 Trends for April 2019 CCI Updates

4. March 2019

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Think Medicare’s April CCI updates are small potatoes? You may reevaluate that stance when you learn there are more than 11,000 additions planned for April 1, 2019. To help make it manageable, watch the three areas below. Our focus: The topic here is Medicare practitioner procedure-to-procedure (PTP) Correct Coding Initiative (CCI) edits that will be […]

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Here’s Why the MPFS Should Be at the Top of Your Modifier Checklist

25. February 2019

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When you think of the Medicare Physician Fee Schedule (MPFS), fees might be the first word that comes to mind. But modifiers should be a close second. Here’s how you can use the MPFS to improve your modifier accuracy for Medicare claims. Start here: To read about the MPFS bilateral indicator and modifier 50, read […]

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Do You Know About Medicare Add-On Code Edits? You Should!

11. February 2019

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Pairing an add-on code with an appropriate primary code is a key factor in bringing in that extra add-on reimbursement. The CPT® manual often provides a listing of appropriate primary codes for an add-on code, but not always. In those cases, you may find answers in Medicare’s Add-On Code Edits, our topic for today. Know […]

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Bring in Correct Bilateral Procedure Pay With These Pro Pointers

7. February 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

4. February 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

28. January 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

24. January 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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