Tag Archive | "MPFS"
Modifier 51 Hints: Your Go-To Guide for the MPFS Multiple Procedure Column
There are nine different Multiple Procedure indicators on the Medicare Physician Fee Schedule (MPFS), meaning there are a lot of payment adjustment possibilities you need to know. Here’s each indicator, an example of a code with that indicator, and a quick look at where modifier 51 comes into play. What Is Modifier 51? The basic […]
Continue reading...Watch April MPFS Update for NGACO Code Changes With a January Twist
Monday, March 18, 2019
Ready for some retroactive MPFS changes? The next Medicare Physician Fee Schedule update may have an April 1, 2019, implementation date, but the effective date is Jan. 1, 2019. The theme for the HCPCS codes involved is Next Generation Accountable Care Organization (NGACO) Model Post Discharge Home Visits. Remember: “MACs will not search their files […]
Continue reading...Bring in Correct Bilateral Procedure Pay With These Pro Pointers
Thursday, February 7, 2019
Choosing medical codes and modifiers for bilateral services can be confusing. Here are a few questions you can ask to help ensure accurate coding and reimbursement for physician claims. Does the Code Descriptor Specify Bilateral? “Bilateral surgeries are procedures performed on both sides of the body during the same operative session or on the same […]
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...Do You Land in the Winner Column for MPFS 2019?
Thursday, December 6, 2018
For the 2019 Medicare Physician Fee Schedule (MPFS), we’ve talked about E/M and a bit about remote monitoring. But now let’s take a general overview of the ups and downs expected for individual specialties. Know Where to Find the Info and What It Means Table 94 of the 2019 MPFS final rule is titled “CY […]
Continue reading...2019 MPFS: Prolonged Preventive Service Codes May Make It On to Telehealth List
Tuesday, September 25, 2018
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 […]
Continue reading...Hot Topic: Get the Scoop on Proposed MPFS 2019 Changes to E/M Coding and Payment
Friday, August 3, 2018
The 2019 proposed Medicare Physician Fee Schedule (MPFS) includes some major potential changes to E/M coding and payment in its 665 pages. Major. Here are the highlights. Just remember that what’s below is proposed and may change before the final rule is implemented. Here’s the Big Payment News About Levels 2-5 Let’s get right to […]
Continue reading...Prep Time! July 2018 MPFS Updates Bring More Than RVU Changes
Friday, June 1, 2018
We’re a month away from the July 2018 Medicare Physician Fee Schedule (MPFS) update. These quarterly changes are easy to overlook, but checking any fee schedule update is important. Even if, for some reason, you’re not interested in RVU changes, there may be changes to indicators (like PC/TC) that affect proper reporting. Here are some […]
Continue reading...Compare 38571-38573 Lymphadenectomy Codes At-a-Glance to Avoid Cutting Reimbursement in Half
Friday, April 20, 2018
If you’re already familiar with laparoscopic bilateral total pelvic lymphadenectomy codes 38571 and 38572, you know the pattern. The second code descriptor builds on the first. When the CPT® 2018 code set added 38573, the new code descriptor followed that pattern, adding quite a few more requirements before you use the new code. Not sure […]
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Thursday, June 13, 2019
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