Tag Archive | "Medicare"

Meet the Latest Modifier-Related RAC Topics

Thursday, November 21, 2019

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You may know that medical coding modifiers can affect payment and bundling rules for your claims, but did you know modifiers are on the radar for Recovery Audit Contractors (RACs), too? Here are some of the recently added audit issues that have links to modifier use. Quick background: Medicare’s RAC program is used to identify […]

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Which Medicare Diabetes Prevention Program Code Is Worth $168 in 2020?

Thursday, November 14, 2019

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The 2020 payment rates are now available for the Medicare Diabetes Prevention Program (MDPP). Here’s a quick look at the codes, rates, and program resources. Compare 2019 and 2020 MDPP Payments The goal of the MDPP Expanded Model is to prevent Medicare beneficiaries who have an indication of prediabetes from developing diabetes. Below you’ll find […]

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How Do You Code Sinuva Placement for NGS Medicare? Find Out Here

Monday, November 4, 2019

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A new HCPCS Level II code lets you report the SinuvaTM implant for nasal polyps, but coding for placement may vary based on the encounter. Medicare Administrative Contractor (MAC) National Government Services has some advice for its providers. Here’s what you need to know if you perform coding for otolaryngology. Update HCPCS Coding for Oct. […]

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Ob-Gyn Coders, Beware This Costly Modifier 24 Myth

Monday, October 21, 2019

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Suppose a Medicare patient presents to your ob-gyn practice for a visit scheduled as a follow-up after cervical lesion biopsy, but the doctor also spends time on counseling and coordination of care related to the malignant tumor the biopsy identified. Can you report an E/M with modifier 24 if the visit is during the biopsy’s […]

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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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