Tag: Medicare Administrative Contractors

CMS-introduces-game-changing-appeal-rights-for-Patients

CMS Enhanced Patient Appeal Procedures

Doctors must consider the implications of altering a patient’s status. The Centers for Medicare & Medicaid Services (CMS) is suggesting novel retrospective and prospective appeal procedures in compliance with a federal district court order from the District of Connecticut. On December 21, the agency unveiled a proposed rule aiming to institute an appeal mechanism for […]
Advanced Imaging Claims Codes

Advanced Imaging Claims Require New Modifiers and G Codes

January 1, 2020, marks the start of the Appropriate Use Criteria (AUC) program educational and operations testing period, at which time Medicare Administrative Contractors (MACs) will begin accepting AUC-related modifiers on claims for advanced diagnostic imaging services furnished to Medicare Part B patients. The voluntary participation period ends December 31, 2019. Know AUC Program Requirements […]
Medical Coding Services, CPT Coding Updates

2019 Codes Subject To Or Excluded From CLIA Edits

The CPT® codes that are considered a laboratory test under the Clinical Laboratory Improvement Amendments (CLIA) change each year, as well as throughout the year, making it difficult for healthcare providers and laboratories to keep up. Here are the CPT codes for 2019 that are subject to or excluded from CLIA edits in easy-to-look up […]
Allzone-New-Medicare-Enrollment-Application

New Medicare Enrollment Application

There is a new version of the CMS-855I Medicare Enrollment Application, which physicians and non-physician practitioners may begin using immediately. Medicare Administrative Contractors will accept the previous version of the application (7/2011) through April 30, and then require you to use the new version (12/18). What’s Changed? The Centers for Medicare & Medicaid Services (CMS) has made the […]