Category: Blog

After patients have a subcortical stroke in the right hemisphere of their brain, more than one in three experience cognitive decline. That decline may be the result of damage to specific pathways in the brain, according to a new study published in Radiology. “Impairment of attention has been observed in patients with both cortical and […]

Medpac Suggests Cutting Medicare Reimbursement For Stand-alone Emergency Departments The Medicare Payment Advisory Commission (MedPAC) recently voted to reduce Medicare reimbursement by 30 percent for off-campus stand-alone emergency departments (ED) in urban areas. The recommendation will be included in the commission’s June 2018 report to Congress. MedPAC expressed concerns that stand-alone EDs in urban areas resulted in […]

Get a jump on five new HCPCS Level II codes going into effect July 1,2018. All are Q codes and they help patients with opioid addiction, knee pain, cystic fibrosis, and hemophilia. Q9991         Injection, buprenorphine extended-release (Sublocade), less than or equal to 100 mg Q9992         Injection, buprenorphine extended-release (Sublocade), greater than 100 mg Sublocade is […]

Blue Cross Blue Shield of Michigan is piloting a bundled payment program with 64 surgeons at seven health systems in the state. Here are the four highlights. BCBSM aims to shave 10 percent off the average cost of non-complicated knee or joint replacements, which can total between $28,000 and $55,000, through the bundled program. The […]

Key: Amount of time spent with the patient indicates which code to use. Coding for physician inpatient services, especially critical care, is deceptively straightforward. The reality is that the details of each code requirement can complicate things to the point of complete confusion. Despite the challenges, there are specific strategies you can use to correctly […]

Beth Morgan, president and CEO of Medical Bill Consultants, has over 40 years of experience coding and billing for various providers and facilities. She provided these three tips: Read the notes carefully. If coders and billers don’t read notes carefully, they might miss a key component that the provider also missed. For example, if the […]

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires us to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status. The […]

2018 brings us new functional endoscopic sinus surgery codes (FESS) which bundle a total ethmoidectomy with both a frontal sinusotomy and a sphenoidotomy with and without removal of tissue.  2018 CPT® also provides a new bundled code for a frontal and sphenoid endoscopic balloon dilation. On initial review of these new codes and the instructions […]

CMS has released its final 2018 Medicare Outpatient Prospective Payment System rule, which cuts payments to hospitals under the 340B Drug Pricing Program and authorizes Medicare to reimburse for knee replacement surgeries performed in outpatient facilities. Here are eight things to know about the 1,133-page final rule. Payment Update: CMS will increase OPPS rates by […]