Archive | Medicare RSS feed for this section

Prep Time! July 2018 MPFS Updates Bring More Than RVU Changes

1. June 2018

0 Comments

We’re a month away from the July 2018 Medicare Physician Fee Schedule (MPFS) update. These quarterly changes are easy to overlook, but checking any fee schedule update is important. Even if, for some reason, you’re not interested in RVU changes, there may be changes to indicators (like PC/TC) that affect proper reporting. Here are some […]

Continue reading...

3 ICD-10-CM Cardiology Coding Tips That Line Up With the Risk-Adjustment Trend

25. May 2018

0 Comments

All the discussions of risk adjustment have put a spotlight on diagnosis coding, and one big way cardiology coders can help is by ensuring they follow the official rules for coding and learn about coding comorbidities, too. Here are some good, old-fashioned rules that will also help ensure your pro-fee cardiology coding follows best practices […]

Continue reading...

2 Knee Arthroscopy Myths You Need to Bust Right Now

23. May 2018

0 Comments

There are a lot of possible variations for knee arthroscopy services, so you’ve got to know where to go for help on coding them. Make sure your knee arthroscopy claims don’t fall victim to these two error-causing myths! Follow the guidance in the Correct Coding Initiative manual. Myth: Report G0289 Along With 29880/29881 for Chondroplasty […]

Continue reading...

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

18. May 2018

0 Comments

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 […]

Continue reading...

After July HCPCS Updates, Match These Meds to Correct Codes Faster

7. May 2018

0 Comments

Thinking about summer? You aren’t the only one! CMS has posted a file with five Q codes that will be effective July 1, 2018. If you code for any of these supplies, plan ahead so you’re ready to change your coding when July comes. Watch mg to Separate SublocadeTM Codes for Opioid Use Disorder First […]

Continue reading...

Get 1 Step Closer to 99285 Perfection With This HPI Primer

26. April 2018

0 Comments

Emergency medicine code 99285 seems to be popping up a lot lately because of potential overuse. To help give you your best chance at coding correctly, it helps to take a close look at each element involved. Today, let’s look at the history of present illness (HPI) requirement. The good news is that most of […]

Continue reading...

Compare 38571-38573 Lymphadenectomy Codes At-a-Glance to Avoid Cutting Reimbursement in Half

20. April 2018

0 Comments

If you’re already familiar with laparoscopic bilateral total pelvic lymphadenectomy codes 38571 and 38572, you know the pattern. The second code descriptor builds on the first. When the CPT® 2018 code set added 38573, the new code descriptor followed that pattern, adding quite a few more requirements before you use the new code. Not sure […]

Continue reading...

Podiatry Alert: Here’s What Caused $330 Million in Improper Payments for Part B and DMEPOS

16. April 2018

0 Comments

We’ve talked about CERT 2017 report results before in this blog, but that’s mostly been Part B. Podiatry coders need to be thinking about DMEPOS, too. And based on the 70.5 percent error rate estimated for podiatry under DMEPOS, practices need to put that on their priority lists. Review the CERT Report Stats The “2017 […]

Continue reading...

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

12. April 2018

0 Comments

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, […]

Continue reading...

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

6. April 2018

0 Comments

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 […]

Continue reading...