Tag: Medicare

Telehealth Reimbursement May Be Changing. How Should Providers Prepare

Telehealth Reimbursement May Be Changing. How Should Providers Prepare?

The future potential of telehealth hinges on how it’s reimbursed. Virtual care may be popular among patients, but if providers can’t get paid for their services, it’s unlikely they’ll be able to continue to provide them. The government has signaled its support for reimbursing some telehealth services, at least in the short term. The Centers […]
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CMS Provides Medicare Reimbursement for More Telehealth During PHE

CMS Provides Medicare Reimbursement for More Telehealth During PHE

CMS recently added 11 new services to the Medicare telehealth services list, qualifying the services for Medicare reimbursement through the COVID-19 public health emergency (PHE). The new telehealth services cover some cardiac and pulmonary rehabilitation services, as well as certain neurostimulator analysis and programming services. The additions to the Medicare telehealth list were made in […]
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Nine Tips for Collecting Patient Balances

Nine Tips for Collecting Patient Balances

Practices have been creative during COVID-19 to ensure safe patient access: Telephone visits. Curbside immunizations. Drive-up virus testing. Even checking patients in for their in-office visits while they wait in the car. However, each of these scenarios poses one significant challenge: Collecting copayments and coinsurance. “With COVID-19, you’ve got to find ways to meaningfully engage […]
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FESS Codes Claims for Improper Payment Adjustments

Check Your FESS Codes Claims for Improper Payment Adjustments

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 endoscopic procedures to the family of functional endoscopic sinus surgery (FESS) codes. Practices are now getting remittance advice […]
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New Patient EM Denials

New Patient E/M Denials: Mystery Solved

New 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 in the same multi-specialty group sees the patient for the first time and bills a new patient E/M […]
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HCPCS Level II Coding Cycles and Procedures

CMS Implements Significant Updates to HCPCS Level II Coding Cycles and Procedures

The 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 (HCPCS) Level II code set. Under the updated procedures, stakeholders will be able to submit code applications on a quarterly basis […]
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Medicare Retires G Codes for Mammograms

Medicare Retires G Codes for Mammograms

Ensure that your practice’s medical coding for preventive screening mammograms aligns with the most recent guidelines during Breast Cancer Awareness Month in October. Coding Mammograms for Medicare The Centers for Medicare & Medicaid Services (CMS) now acknowledges the CPT® mammogram codes, aligning with industry standards. This streamlines the process for coders to accurately document mammogram […]
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Coding CAR T Cancer Treatment Revolutionized

Coding CAR T: Cancer Treatment Revolutionized

Now 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 CAR-T, novel cutting-edge, often curative treatments that utilize the patients’ own genetically modified immune cells to fight cancer. The […]
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