MACs may be applying the multiple endoscopy rules incorrectly. In the 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized the proposal to apply the special rule for multiple...
More InfoNew patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty...
More InfoWith an election year just about upon us, there are a number of changes coming from the current administration that are going to impact healthcare in 2020. Changes in allowable benefits, home health, hospice carve-ins, and new CPT codes for...
More InfoThe Centers for Medicare & Medicaid Services (CMS) announced that, beginning in January 2020, CMS will implement shorter and more frequent HCPCS Level II coding cycles for requests to modify the Healthcare Common Procedure Coding System...
More Info86% of medical group practices in an MGMA report said regulatory burden rose in the last year, with prior authorizations and the Quality Payment Program adding to that burden. A vast majority of medical group practices experienced growing...
More InfoOctober is Breast Cancer Awareness Month. Make sure your practice’s medical coding mammograms for preventive screening mammograms is up to date with current guidelines. Coding Mammograms for Medicare The Centers for Medicare & Medicaid...
More InfoNow that revolutionary cancer therapy, Chimeric Antigen Receptor T-cell (CAR T-cell), is covered, let’s take a look coding CAR T. Last month the Centers for Medicare & Medicaid Services (CMS) finalized the long-sought rules for coverage of...
More InfoProviders are encouraged to file protective appeals. “In section XI of the preamble of the proposed rule, we discussed the growing number of Provider Reimbursement Review Board (PRRB) appeals made by providers and the action initiatives that are...
More InfoA look at the proposed Medicare Physician Fee Schedule. As you may be aware, the proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially published on Aug. 14, 2019. There are many components to the rule, including a proposed...
More InfoSeveral changes to the Merit-based Incentive Payment System (MIPS) track of the Quality Payment System (QPP) are outlined in a proposed rule for 2020 revisions to payment policies under the Physician Fee Schedule (PFS). Most of the proposed...
More InfoOn Aug. 15, 1935, Will Rogers died in a plane crash near Point Barrow, Alaska. He is an Oklahoma legend and one of the best political satirists and commentators ever. I often wonder what his commentary would be on the state of U.S. politics in...
More InfoCMS recently proposed Merit-Based Incentive Payment System changes in 2020 and beyond, including a new participation framework and higher performance thresholds. CMS is planning to overhaul reporting for the Merit-Based Incentive Payment System...
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