Posted on 08. May, 2013 by rpandit.
Many MUEs make sense, but for those that don’t, you can fight back.
By now, most practices are familiar with Medicare’s medically unlikely edits (MUEs), which CMS instituted to prevent overpayments caused by gross billing errors. On April 1, CMS updated the MUE listing, and some of your favorite codes may now be limited by the bundles. When you scour your unpaid claims, make sure you are watching for MUE denials to ensure that you’re getting paid when appropriate but that you fight back when your claims are inappropriately denied.”
Posted on 07. May, 2013 by jennifer.godreau.
Nerve conduction study (NCS) coding saw a major overhaul for 2013, requiring you to swap counting nerves for counting tests. To ensure your choice of units doesn’t run afoul of the new rules, check out the just released March 2013 CPT® Assistant. You’ll get the nuts and bolts of the procedures 95907-95913 describe, as well as clarification of what counts as a single study. And don’t miss the six different coding scenarios that help you see the rules in action.
Posted on 24. Apr, 2013 by rpandit.
However, don’t assume your HPSA bonus will continue.
As many practices are aware, medical offices nationwide were waiting to find out whether legislators halted a 26.5 percent pay cut that the 2013 Fee Schedule predicted, which would have brought the 2013 conversion factor down to $25.0008. In addition, practices were facing
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Posted on 23. Apr, 2013 by jennifer.godreau.
The CPT® trend of lumping multiple services into a single code has left many questioning whether transcatheter service claims contain too many or too few codes. Help is at hand in the just-released February 2013 CPT® Assistant. You’ll get authoritative guidance on coding catheterization in addition to thrombolysis, feel more secure choosing between primary and secondary mechanical thrombectomy codes, and benefit from coding tips for vena cava filter services, intravascular foreign body retrieval, and carotid stent placement, too.
Posted on 10. Apr, 2013 by rpandit.
News: Code Search Result’s Color Identifies Keyword-Code Mapping Source
If you’ve ever wondered where a code suggestion for a keyword came from, SuperCoder’s new color-coded search results reveal the definitive source. In SuperCoder’s Code Search box [Keyword tab], when you enter a keyword that exists in a codeset’s index, the index’s suggested codes appear in purple and red. Additional codes suggested by SuperCoder’s extensive Keyword to Code Correspondence Helper (KECH) appear in blue and green. Often, the first code entry suggestion will be in purple and red meaning the result from the code book index and KECH match.
The color coding’s pinpointing of the definitive source helps you:
Posted on 08. Apr, 2013 by jennifer.godreau.
Whether you’re concerned about Multiple Procedure Payment Reduction changes or want to dig in to group practice electronic prescribing rules, the first 2013 issue of CPT® Assistant has what you need. This issue takes on the 2013 Medicare Physician Fee Schedule (MPFS) presenting the must-know highlights from the massive final rule. Molecular pathology and percutaneous coronary intervention coding updates, Physician Quality Reporting System (PQRS) payments, value-based modifier news, and fee calculation insights are just some of the hot topics featured in this MPFS roundup.
A quick search on…
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Posted on 08. Apr, 2013 by rpandit.
CCI takes note of these tables. Shouldn’t you?
CPT® doesn’t designate primary codes for every add-on code, but CMS offers a few clues in Transmittal 2636, Change Request 7501, effective April 1, 2013.
Background: An add-on code reports a service that is “always performed in conjunction with another primary service. An add-on code is eligible for payment only if it is reported with an appropriate primary procedure performed by the same practitioner. An add-on code is never eligible for payment if it is the only procedure reported by a practitioner,” states the Transmittal. “Rarely contractors may allow with appropriate submitted documentation, either pre-pay or on appeal, payment for a primary code and add-on code on two consecutive dates of service if the services are appropriately related.”
Posted on 08. Apr, 2013 by rpandit.
But RVU changes still in effect.
Optometrists can expect a reprieve from the dreaded 2013 pay cut to the Medicare Physician Fee Schedule (PFS). Congress voted to halt the 26.5 percent rate cut that was tied to the sustainable growth rate (SGR) formula.
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Posted on 25. Mar, 2013 by rpandit.
Hint: Use additional code for instillation when reporting 44705
If your gastroenterologist performs fecal bacteriotherapy as a treatment for Clostridium difficile infections, don’t forget to look at payer policies before you report the assessment and preparation of the fecal microbiota sample with the newly introduced CPT®code 44705.
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Posted on 11. Mar, 2013 by rpandit.
In the Q2 updates to the Medicare Physician Fee Schedule, CMS offers payment boosts for several procedures, including catheter placement and cardiac Doppler monitoring. Although the Q2 updates have an official implementation date of April 1, many of the changes are effective retroactive to Jan. 1, 2013.
You’ll now be able to collect more when you perform selective catheter placement (36222-36228) bilaterally. Previously, the bilateral procedure indicator on these codes was “0,” which meant that no additional payment was assigned when surgeons performed the procedure on both sides. However, effective Jan. 1, 2013, the bilateral indicator is “1,” so you can append modifier 50 (Bilateral procedure) and the payment amount will be 150 percent of the fee schedule RVUs.