Tag Archive | "Medicare"
Do You Know About Medicare Add-On Code Edits? You Should!
Pairing an add-on code with an appropriate primary code is a key factor in bringing in that extra add-on reimbursement. The CPT® manual often provides a listing of appropriate primary codes for an add-on code, but not always. In those cases, you may find answers in Medicare’s Add-On Code Edits, our topic for today. Know […]
Continue reading...Primary Care and Specialists Need to Know These Twin Add-On Codes by 2021
Monday, January 28, 2019
The 2019 MPFS proposed rule discussed potential add-on G codes to represent E/M visit complexity. Here’s a quick look at the intent of the proposed codes and what the final rule had to say about their implementation in 2021. See What Happens to This Code for Specialists In the 2019 Medicare Physician Fee Schedule (MPFS) […]
Continue reading...Here’s How Medical Documentation Can Help or Hurt for Reimbursement
Thursday, January 24, 2019
The 2018 CERT report estimates 58 percent of Medicare improper payments were caused by insufficient documentation (and this is an ongoing trend). More than half is nothing to sneeze at, especially when you consider that those documentation problems could lead to having to repay Medicare or having to spend time working on underpayments. Here’s a […]
Continue reading...Outpatient Coders: Are These C Codes on Your Procedure Reporting List?
Tuesday, January 22, 2019
The HCPCS 2019 code set features several new C codes related to reporting procedures. If you use C codes, make sure you’ve got these updates on your radar. Reminder: HCPCS C codes are intended for use by Outpatient Prospective Payment System (OPPS) hospitals. The codes are used to report device categories, new technology procedures, and […]
Continue reading...Say Cheese! Medicare Is Paying for Photo and Video Evals in 2019
Thursday, January 17, 2019
If a picture is worth 1,000 words, how much is evaluating a picture worth? Medicare has taken a stance on that. As of Jan. 1, 2019, Medicare is paying for remote evaluation of pre-recorded patient videos and images reported using G2010. Here’s what we know from the Medicare Physician Fee Schedule Final Rule. Compare Our […]
Continue reading...Take the Mystery Out of the MPFS Conversion Factor and Calculations
Monday, January 14, 2019
In the 2019 Medicare Physician Fee Schedule (MPFS), the conversion factor is 36.0391 compared to 35.9996 in 2018. But that sort of information helps only if you know what a conversion factor is and what to do with it. Here’s a primer you can turn to when you need to brush up on your MPFS […]
Continue reading...Here’s How MIPS Participation Eligibility Shrinks and Grows in 2019
Thursday, January 10, 2019
We’re in the third year of the Quality Payment Program (QPP), which includes the Merit-based Incentive Payment System (MIPS). The QPP is connected to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Because MIPS may result in Medicare payment adjustments up or down, knowing whether you’re required to participate is an essential first […]
Continue reading...HCPCS 2019: Get to Know New Code G2012 for Virtual Check-In
Monday, December 17, 2018
Payment for non-face-to-face communication with patients isn’t the most clear-cut topic. But with new 2019 HCPCS code G2012, you’ve got an intriguing option for virtual check-ins with Medicare patients. Ready to learn more? Dig In to the Long Descriptor for G2012 The first place to learn about the code is the long code descriptor: G2012 […]
Continue reading...Pop Quiz: Test Your Assumptions About QPP 2019 Payment Year
Monday, December 10, 2018
Understanding the Medicare Quality Payment Program (QPP) is tough. But the data Medicare released from the 2017 performance year shows you were up for the challenge. And that’s good news because the 2017 performance year affects 2019 Medicare payments and maybe has helped you prepare for the 2019 performance year, too. Let’s see how you […]
Continue reading...Drum Roll: What Does MPFS 2019 Final Rule Say About E/M?
Monday, November 5, 2018
Medicare released the CY 2019 Medicare Physician Fee Schedule (MPFS). One of the big questions from the proposed rule was whether E/M payment rules would change. Here are some highlights on what made it into the final rule for E/M and what didn’t. The News You’ve Been Waiting for … The proposal to combine payment […]
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Monday, February 11, 2019
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