Tag Archive | "medicare physician fee schedule"
GI Coding: Why Is Modifier 53 on the Medicare Physician Fee Schedule?
The Medicare Physician Fee Schedule (MPFS) includes special pricing for four colonoscopy codes when you append modifier 53 (Discontinued procedure). Here’s what you need to know about appending modifier 53 to these codes and the payment you can expect. Compare Rates for Total and Discontinued Colonoscopies Below are the four codes on the 2020 first […]
Continue reading...Modifier 51 Hints: Your Go-To Guide for the MPFS Multiple Procedure Column
Thursday, June 13, 2019
There are nine different Multiple Procedure indicators on the Medicare Physician Fee Schedule (MPFS), meaning there are a lot of payment adjustment possibilities you need to know. Here’s each indicator, an example of a code with that indicator, and a quick look at where modifier 51 comes into play. What Is Modifier 51? The basic […]
Continue reading...Watch April MPFS Update for NGACO Code Changes With a January Twist
Monday, March 18, 2019
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 […]
Continue reading...Bring in Correct Bilateral Procedure Pay With These Pro Pointers
Thursday, February 7, 2019
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 […]
Continue reading...Get the Latest on Changes to Medicare’s 2019 History Documentation Requirements
Thursday, December 20, 2018
We’ve been talking a lot about the 2019 Medicare Physician Fee Schedule final rule, but when there are changes to E/M rules, there can never be enough information, right? CMS recently released a response to a question that arose during a provider call about what parts of history ancillary staff or the beneficiary can document […]
Continue reading...Hot Topic: Get the Scoop on Proposed MPFS 2019 Changes to E/M Coding and Payment
Friday, August 3, 2018
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 […]
Continue reading...Ups and Downs, MACRA Modifiers, and E/M DGs in MPFS 2018 Proposed Rule
Tuesday, July 25, 2017
Part 3 of our proposed rule extravaganza is about the Medicare Physician Fee Schedule (MPFS) 2018 proposed rule. (Part 1 was QPP and Part 2 was OPPS). Let’s get down to business, checking out some highlights explained in recent issues of Medicare Compliance and Reimbursement. Plusses and Minuses The proposed 2018 conversion factor is 35.99, […]
Continue reading...Quick Q&A to Take Multiple Scope Know-How Up a Notch
Friday, December 30, 2016
Happy New Year! We’ve made it to the last SuperCoder blog post for 2016, and what a year it’s been. Sometimes after a whirlwind of chaos, it’s good to get back to the fundamentals. With that in mind, today we’re looking at some simple tips for the next time you’re dealing with the multiple scope […]
Continue reading...Clean Up Your Cardiovascular Stress Test Coding With MPFS Insights
Tuesday, December 20, 2016
Depending on your sense of humor, focusing on the topic of stress tests during the last two crazy weeks of the year might just make you smile. Or groan. Either way, if you code cardiovascular stress tests, you may find some useful hints in today’s post. Start With Stress Test Codes 93015-93018 Codes 93015-93018 are […]
Continue reading...5 Fast Facts From the 2017 MPFS Final Rule
Friday, December 9, 2016
Digesting the hundreds of pages in the MPFS 2017 Final Rule is best done in small bites. Here are five tidbits to get you started. 1. The Conversion Factor Goes Up a Little The 2017 conversion factor is just a bit bigger than the 2016 conversion factor: 2016: 35.8043 2017: 35.8887. Read about it: You’ll […]
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Thursday, January 30, 2020
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