Tag Archive | "Medicare"

Catch Radiation and Home Visit Changes Coming Soon to Medicare Manual

Thursday, August 15, 2019

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Medicare has announced two updates to the Medicare Claims Processing Manual (MCPM). The implementation date is set for Aug. 27, 2019, but they’re effective all the way back to Jan. 1, 2019. If your physician performs home visits or superficial radiation treatment, you’ll want to be sure your knowledge is up to date. 1. Eliminate […]

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MPFS 2020 Proposed Rule: E/M Blended Payment for 2021 Is Dead

Monday, August 5, 2019

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Another day, another change to E/M plans for 2021! Medicare has released the 2020 proposed rule for the Medicare Physician Fee Schedule (MPFS), bringing in the recent AMA plan to revise E/M coding in 2021. But what does the MPFS say about Medicare payment for office/outpatient visits in 2021? Here’s the scoop. Know What to […]

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Patient Nervous About Doctors? Update Medicare Coverage Rules for ABPM

Tuesday, July 30, 2019

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A recent update brought Medicare coverage changes for both suspected white coat hypertension and suspected masked hypertension. Here’s your chance to get a handle on the new rules, including a change to the threshold for hypertension. Keep Patients Calm With New ABPM Coverage Medicare coverage of ambulatory blood pressure monitoring (ABPM) for patients with suspected […]

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Smash 3 Myths to Upgrade Your Mammography Coding and Coverage Knowledge

Thursday, July 18, 2019

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Mammography is a common service, but radiology coders need to learn some not-so-common rules. Take your know-how to the next level by getting to the truth about these myths. Myth 1: Mammography Is for Women Only Medicare’s National Coverage Determination (NCD) for Mammograms states that “diagnostic mammography is a radiologic procedure furnished to a man […]

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CCI Modifiers: July 1 Update to Modifier 59 Rule Is Now in Force … and More

Tuesday, July 16, 2019

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Modifiers are the key to overriding Correct Coding Initiative (CCI) edits, so let’s give them the attention they deserve. We’ll start with a recent rule update and move on to helpful hints about CCI-associated modifiers in general. Which CCI edits? Our focus here will be Medicare CCI Procedure-to-Procedure (PTP) edits for physicians and practitioners. Do […]

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Modifier 25 Scavenger Hunt! Can You Find These Answers?

Tuesday, May 21, 2019

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Keeping up with modifier 25 rules can be intimidating, so let’s add a little fun by seeing if you can unearth the answers to these questions at the locations provided. Ready, set, go! 1. Is This a Separate E/M? You may have the descriptor memorized for modifier 25 (Significant, separately identifiable evaluation and management service […]

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Clear Up Coverage Questions for Medicare’s Hepatitis B Screening

Friday, May 17, 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

Monday, May 6, 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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Make the CCI Manual Your Go-To Guide for Shoulder Arthroscopy With Debridement

Thursday, March 21, 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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Keep Your Finger on the OIG Pulse by Knowing Where to Find Audit Targets

Tuesday, March 12, 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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