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Clear Up Coverage Questions for Medicare’s Hepatitis B Screening

17. May 2019

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The percentage of people who have hepatitis B but don’t know it could be as high as 67 percent, and the opioid epidemic is fueling an increase in infections, according to the Department of Health and Human Services (HHS). That’s one reason screening is so important. Medicare’s coverage rules for hepatitis B screening are specific, […]

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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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$325 Million in Office Visit Underpayments! How Much Is Yours?

8. April 2019

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Audit discussions often focus on the fear of upcoding and having to hope that repaying the extra amount is the worst of the consequences. But downcoding is another problem area affecting your payments and more. Here’s why you should never purposely downcode your services. Start With a CERT Story Wondering about the $325 million in […]

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Simplify Cystocele Coding With These ICD-10-CM and CPT® Pointers

25. March 2019

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Urogynecology brings together urology and gynecology, specifically focusing on treating pelvic floor disorders. One diagnosis urogynecology coders need to be familiar with is cystocele, our topic for today. Tie Your Diagnosis to These ICD-10-CM Codes A cystocele occurs when the wall between the bladder and vagina weakens, causing a protrusion. You should report this condition […]

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Make the CCI Manual Your Go-To Guide for Shoulder Arthroscopy With Debridement

21. March 2019

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Before you code debridement with shoulder arthroscopy, make sure you know what the Medicare Correct Coding Initiative (CCI) manual has to say. You’ll find the highlights here to help you get started. Where to look: You’ll find these instructions in chapter IV, section E, of the Medicare CCI manual. Same Shoulder? Stick to the Basic […]

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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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