Tag Archive | "Medicare"

Find Flu Vaccine Codes Fast for Cleaner Medicare Claims

Thursday, October 17, 2019

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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. […]

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Get the Facts About Reporting Glaucoma Screening to Medicare

Monday, October 14, 2019

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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 […]

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

Thursday, October 10, 2019

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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 […]

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Get Pro/Tech Component Refresher From October MPFS Update

Monday, September 23, 2019

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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 […]

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Learn Coronary Artery Anatomy According to CPT® and CCI

Thursday, August 22, 2019

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When your job is converting medical documentation into codes, your knowledge of medical anatomy has to be shipshape. But you’ve got the added complication that the code set you’re using may have its own definitions for specific terms. Case in point: CPT® guidelines set out five major coronary arteries with coronary artery branches for only […]

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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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