Tag Archive | "Medicare"

Pop Quiz: Test Your Assumptions About QPP 2019 Payment Year

Monday, December 10, 2018

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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 […]

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Drum Roll: What Does MPFS 2019 Final Rule Say About E/M?

Monday, November 5, 2018

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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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On the Cutting Edge? Check Out These ‘Remote’ CPT® 2019 Additions With MPFS Tips

Wednesday, October 17, 2018

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The CPT® 2019 code set is adding to your options for remote services. Here’s a rundown of the changes you can expect for certain remote monitoring services as well as EHR consultative time. Turn to 9945X for Remote Physiologic Monitoring The new code set will add codes for remote physiologic monitoring (like weight, BP, pulse […]

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Smart Move: Know These Top Medicare Denial Reasons AND How to Avoid Them

Wednesday, October 10, 2018

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  Let’s put data to work to help prevent denials! CGS is one of the Medicare contractors that provides information on top claim denial reasons, and here we’ll take a look at some denial triggers from August 2018 and how you can prevent them. Check Status Before Reporting Duplicate Service Reporting the exact same service […]

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Do You Know the Answers to These Medicare Disaster Relief Questions?

Wednesday, October 3, 2018

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Because of Hurricane Florence, CMS issued several waivers in North Carolina, South Carolina, and Virginia to help with access to healthcare. Even if you’re not in an affected area, this should be a reminder that disaster prep isn’t just about working in theory. You need to understand it well enough to apply it. Below you’ll […]

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2019 MPFS: Prolonged Preventive Service Codes May Make It On to Telehealth List

Tuesday, September 25, 2018

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If telehealth is on your radar, you’ll want to watch the Medicare Physician Fee Schedule for 2019. The MPFS 2019 proposed rule discusses potential changes to Medicare telehealth services, specifically the addition of G0513 and G0514 to the Medicare telehealth list. Get a closer look at these codes so you’ll better understand them and the […]

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3 Helpful Hints for Better Subsequent Hospital Care E/M Coding

Tuesday, September 18, 2018

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Subsequent hospital care E/M codes 99231-99233 have some oddities that can trip you up if you don’t use these codes often (and even if you do). Improve your E/M coding accuracy by keeping these three pointers in mind. 1. Look for 2 of 3 With Interval History Option The descriptors for 99231, 99232, and 99233 […]

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Modifier 58 or 78? Master These Confusing Modifiers

Monday, August 13, 2018

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Knowing when to use modifiers 58 and 78 isn’t easy. Base your choices on this straight-from-Medicare guidance to help ensure cleaner claims. Make Modifier 58 Your Choice for Anticipated Procedures Modifier 58 (Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period) is the focus […]

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Top Nuances to Know for the Medicare Card MBI Roll-Out

Monday, August 6, 2018

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Medicare began mailing out new cards in April 2018 to meet the deadline of replacing Social Security numbers/Health Insurance Claim Numbers (HICNs) with Medicare Beneficiary Identifiers (MBIs) by April 2019. Here are some tips you may have missed to help you with the transition. Don’t Use the Dashes! On the new Medicare cards and in […]

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3 Things to Know About Advanced Practice Providers in Your Practice

Friday, July 20, 2018

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Advanced practice providers (APPs), sometimes known as non-physician practitioners (NPPs), are essential members of the healthcare team and serve a lot of roles. But, of course, “essential” doesn’t mean they’re always easy to code for. Make sure you keep these top pointers in mind when you’re completing claims for APPs, such as physician assistants, certified […]

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