Archive | Medicare RSS feed for this section

Meet the Latest Modifier-Related RAC Topics

21. November 2019

0 Comments

You may know that medical coding modifiers can affect payment and bundling rules for your claims, but did you know modifiers are on the radar for Recovery Audit Contractors (RACs), too? Here are some of the recently added audit issues that have links to modifier use. Quick background: Medicare’s RAC program is used to identify […]

Continue reading...

Which Medicare Diabetes Prevention Program Code Is Worth $168 in 2020?

14. November 2019

0 Comments

The 2020 payment rates are now available for the Medicare Diabetes Prevention Program (MDPP). Here’s a quick look at the codes, rates, and program resources. Compare 2019 and 2020 MDPP Payments The goal of the MDPP Expanded Model is to prevent Medicare beneficiaries who have an indication of prediabetes from developing diabetes. Below you’ll find […]

Continue reading...

Highlight E/M, Opioid Use Treatment, PAs, and Single-Disease Care in 2020 MPFS Final Rule

11. November 2019

0 Comments

Medicare has released the Medicare Physician Fee Schedule (MPFS) for 2020. Let’s see how it stacks up against some of the proposals from Medicare that we looked at back in August. Expect Separate Payment for E/M Office Levels in 2021 Even though we’re still in 2019, a lot of us have 2021 E/M coding changes […]

Continue reading...

How Do You Code Sinuva Placement for NGS Medicare? Find Out Here

4. November 2019

0 Comments

A new HCPCS Level II code lets you report the SinuvaTM implant for nasal polyps, but coding for placement may vary based on the encounter. Medicare Administrative Contractor (MAC) National Government Services has some advice for its providers. Here’s what you need to know if you perform coding for otolaryngology. Update HCPCS Coding for Oct. […]

Continue reading...

Ob-Gyn Coders, Beware This Costly Modifier 24 Myth

21. October 2019

0 Comments

Suppose a Medicare patient presents to your ob-gyn practice for a visit scheduled as a follow-up after cervical lesion biopsy, but the doctor also spends time on counseling and coordination of care related to the malignant tumor the biopsy identified. Can you report an E/M with modifier 24 if the visit is during the biopsy’s […]

Continue reading...

Find Flu Vaccine Codes Fast for Cleaner Medicare Claims

17. October 2019

0 Comments

In early October 2019, flu activity was low, according to the Centers for Disease Control and Prevention (CDC). But hopefully vaccinations will land in the “widespread” category for this flu season. A high volume of services means a high volume of coding, though, so protect your Medicare reimbursement with this guidance on flu vaccination coding. […]

Continue reading...

Get the Facts About Reporting Glaucoma Screening to Medicare

14. October 2019

0 Comments

Before you report glaucoma screenings to Medicare, go through this quick Q&A to be sure you’ve got all the bases covered. The Medicare Benefit Policy Manual, Chapter 15, Section 280.1, is your source for information about glaucoma screenings that you report to Medicare, and we’ve put together the major points for reporting to Part B […]

Continue reading...

Get the Scoop on Proposed Medicare Codes for Managing 1 Chronic Condition

10. October 2019

0 Comments

You’ve got Chronic Care Management (CCM) codes when a patient has multiple chronic conditions to manage, but what about when there’s just one? To help solve the problem, Medicare wants to introduce new codes for Principal Care Management (PCM). Here’s more on that from the 2020 Medicare Physician Fee Schedule (MPFS) proposed rule. Start With […]

Continue reading...

Your Guide to CCI Trends for the End of the Year

30. September 2019

0 Comments

On Oct. 1, 2019, there will be 118 new National Correct Coding Initiative (NCCI or CCI) edits for physicians reporting to Medicare. Keep your coding up to date and in compliance with the edits with this quick overview featuring path/lab, allografts, venous procedures, and radiation oncology. Keep in mind: The edits we’re talking about here […]

Continue reading...

Get Pro/Tech Component Refresher From October MPFS Update

23. September 2019

0 Comments

When you think of professional component and technical component, Medicare’s division of a single code may spring to mind. But the October 2019 update to the Medicare Physician Fee Schedule (MPFS) has a dermatology example that shows there’s more than one way to think about PC/TC. Here are the details. RVUs for PC + TC […]

Continue reading...