Archive for 'Provider News'

ICD-9 Coding: Keep Five Digits in Mind When Coding Diabetic Manifestations

Posted on 25. Mar, 2014 by .

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Don’t default to 250.00 — follow these three crucial tips to find the right ICD-9 code.

With all of the talk about ICD-10 coding, it’s easy to fall behind in your ICD-9 skills. But if you want to keep collecting for your claims through the end of September, you should continue to hone your ICD-9 coding finesse. The following tips will help you code ophthalmic manifestations of diabetes so you can collect for all of your services.

1. Crack the Decimal Place Code (more…)

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Physician Note: NPs Without Masters’ Degrees Face Issues With PECOS

Posted on 12. Mar, 2014 by .

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Plus: False Billings Lead to Mail Fraud Charge for Texas Physician

If your nurse practitioner is trying to order and refer Medicare services, he’d better have a master’s degree, or your enrollment process will be filled with headaches. That’s the word from a Feb. 19 Medicare Open Door Forum. (more…)

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Part B Coding: Check These Answers to 5 Burning Medicare Questions

Posted on 26. Feb, 2014 by .

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From coding to billing and beyond, get the answers you’re seeking straight from the source.

Medicare guidelines are not only confusing because they are ever-changing, but they’re also difficult to interpret because we hear advice from so many varying sources. However, even if you get coding tips from a colleague, that doesn’t mean that Medicare agrees with them. (more…)

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CPT® 2014: Check Is Not in the Mail for New Telephone/Internet Consult Codes

Posted on 10. Feb, 2014 by .

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Sadly, the Final Rule does not include any RVUs for 99446-99449.

Each year when the new edition of CPT® is issued, Part B practices get very excited about the potential for payment from newly established codes. Although this does often come to fruition and you are able to collect for new services, practices can also be let down by low or no reimbursement assigned to new codes.

Now that the 2014 Medicare Physician Fee Schedule (more…)

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Part B Payment: 3 FAQs About 2014 Medicare Payments Help You Collect

Posted on 22. Jan, 2014 by .

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From the new conversion factor to the sequestration debacle, we’ve got the answers.

With the New Year you’ll find new payment regulations that can seriously impact your practice’s bottom line. But you can help iron out the wrinkles that these rules create by checking out the following three questions submitted to the Insider, as well as advice that can help you navigate the Part B payment terrain.

Question 1: I read in your last issue that Congress voted to delay the 20.1 percent conversion factor cut until the end of March. Was that cut finalized, and if so, what is the new conversion factor?

Answer:

Stay on top of Medicare news and remain compliant with Medicare Compliance & Reimbursement. Get the reimbursement you deserve every month. Click here to buy.

(more…)

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Part B Compliance Coach: Focus on 5 Areas for Improvement in Your Provider Documentation

Posted on 08. Jan, 2014 by .

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While EMRs improve legibility, they may lead to other issues.

When your practice faces an audit, the payer is not only going to look at your coding accuracy, but also your documentation compliance. If you fall short, you could be setting your practice up for paybacks, fines, or worse.

Ensure your providers’ documentation (more…)

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Validate your practice’s CPT® coding to ensure compliance with definitive guidance from the AMA offered in Code Connect

Posted on 08. Jan, 2014 by .

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The time for the ICD-10 changes has finally arrived and with innumerable coding and billing changes every practice is trying hard to ensure a smooth transition and report the correct CPT codes. From tracing the countdown to the transition, speeding up the training process, maintaining two coding systems, policies and procedures to documentation and systems, it will impact everyone in the healthcare system. With the new challenges of the diagnosis coding system, RAC expansion and MACs increasing focus on the do’s and don’ts of coding and billing , it is difficult to ensure continuity of claims processing and increased/uninterrupted cash flow.

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CPT® 2014: Prepare Now for Last-Minute Changes to CPT® 2014

Posted on 19. Dec, 2013 by .

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Primary code updates make a big difference for your +93463 claims.

If your shiny new CPT® 2014 manual has arrived, the time has come to start adding your own notes to it. The AMA has updated its 2014 (and 2013) Errata and Technical Corrections document with some changes you need to know, and we’ve got four of the biggest changes outlined below.

Tip:

Stay on top of Medicare news and remain compliant with Medicare Compliance & Reimbursement. Get the reimbursement you deserve every month. Click here to buy.

(more…)

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Endoscopy Coding: Prepare for CPT® 2014 Esophagoscopy Overhaul

Posted on 11. Dec, 2013 by .

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Distinguish ‘rigid’ and ‘flexible’ scopes.

You’ll need to “rewrite” your esophagoscopy reporting beginning Jan 1, 2014 because CPT® entirely rewrites the codes in that section of the CPT® manual.

With 12 new codes, two deleted codes, and 14 revised codes in the range 43191-43232, you have a lot to learn by the first of the year. Read on to make sure you’re ready with our expert tips.

Differentiate Codes By Scope Type (more…)

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Emergency Medicine: Yes You Can Bill Emergency Services for Patients in Custody

Posted on 27. Nov, 2013 by .

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Know your rights when submitting claims to Medicare patients brought in by law enforcement personnel

CMS recently released clarifying language on Medicare claims for patients in the custody of law enforcement. While this is presumably intended to just be a clarification of existing CMS policy, the description of “prisoner” seems quite broad. With the exclusions of those actually “imprisoned” in a long term corrections facility; the remainders of these patients typically get their more serious care in the ED. The resulting paradox for ED providers remains the combination of an EMTALA mandate to screen for emergency medical conditions and at least stabilize or transfer the patient and a federal regulation prohibiting payment for those same services. (more…)

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