Category: Blog

Medicare claims that do not meet date format requirements will be rejected. The Centers for Medicare & Medicaid Services (CMS) has released date formatting guidelines for the CMS-1500 claim form, which are effective for claims received on or after July 30. When date formatting requirements are not met, Medicare Administrative Contractors will return claims as […]

The CMS’ proposed Medicare Physician Fee Schedule for 2019 includes changes to the quality payment program and a slight increase in the anesthesia conversion factor. Here’s what you need to know: The national conversion factor for anesthesia services will see an increase from $22.1887 to $22.2986. The increase includes the 0.25 percent positive and budget […]

A major shift in the reporting of transgender issues is at hand. They’re here, but it won’t be until sometime until after 2022 that the United States is expected to adopt the codes of ICD-11 – the new International Classification of Diseases, Version 11 – released by the World Health Organization (WHO) in Geneva. According […]

Clinical diagnostic laboratories can look forward to 12 new laboratory codes were effective April 1 and one code effective retroactively January 1. The Centers for Medicare and Medicate Services (CMS) released the changes May 5, 2018. The new codes are contractor priced until addressed at the annual Clinical Laboratory Public Meeting in July. All the […]

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 […]

The ICD-10-CM Tabular List of Diseases and Injuries 2018 Addenda provides insight to future diagnosis coding. Let’s review what is new, deleted, and revised in chapters 1-7. In future months, we will cover additional chapters. Chapter 1: Certain Infectious and Parasitic Diseases (A00-A09) Two codes are added under A04.7: A04.71 Enterocolitis due to Clostridium difficile, […]

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 […]