TCN Medical Coding Blog

Be Prepared for the X Factor - 4 New HCPCS Modifiers Effective Jan 1, 2015.

Sep 07, 2014
In an effort to reduce inappropriate claim payments due to incorrect use of modifier 59, The Centers for Medicare and Medicaid Services (CMS) will roll out four new HCPCS modifiers to describe specific circumstances when it is appropriate to override a CCI edit. These -X modifiers become effective on January 1, 2015.

CMS Changes to the Use of Modifier -59

Aug 26, 2014
CMS is establishing four new HCPCS modifiers to define subsets ofthe - 59 modifier, a modifier used to define a "Distinct Procedural Service."

AMA Forecasts Over 500 Changes to the 2015 CPT Code System.

Aug 26, 2014
The AMA states that there are over 500 changes to the 2015 CPT code system.

Medicare Fraud Hard to Stop, But Predictive Analytics Technology Helping

Aug 16, 2014
Medicare says its new high tech predictive analytics system “is successfully doing its job of pointing the spotlight on bad behavior and prioritizing the most egregious situations for investigation.”

Increased Audits of E&M Services by CMS - Recommendations from OIG

Jun 19, 2014
In May of 2014, the Office of the Inspector General (OIG) released a report detailing its findings regarding Medicare payments for evaluation and management (E/M) services. E/M services are performed by physicians in order to assess and manage a beneficiary's health.

Don’t Let ICD-10 Orthopaedic Injury Coding Trip You Up

May 18, 2014
Recognize new coding conventions and brush up on your anatomy for proper ICD-10 coding.

Tiny Sliver of Doctors Account for Big Chunk of Medicare Costs

Apr 10, 2014
A tiny sliver of doctors and other medical providers, including one physician who billed more than $20 million alone, accounted for an outsize portion of Medicare's 2012 costs. WSJ's Christopher Weaver reports on Lunch Break. Photo: AP.

CMS’ New 2/12 1500 Claim Form: Are You Ready? April 1st Deadline is Here

Mar 31, 2014
Even if you've been filing Medicare claim form 1500 for years, effective April 1, 2014 your process is about to change.

ICD-10 deadline won’t be delayed, Tavenner tells HIMSS

Feb 28, 2014
Providers, payers and claims clearinghouses can look for no relief from the looming, Oct. 1 compliance deadline for the nationwide conversion to the ICD-10 family of diagnostic and procedural codes, the head of the CMS said Thursday. But some case-by-case exemptions will be made for providers having a tough time meeting their Stage 2 meaningful-use targets, she said.

Take a Refresher on Coder Liability

Jan 16, 2014
In addition to acquiring all the necessary tools and education needed to code and bill, you also are responsible to adhere to regulations governing reimbursement. Failure to perform these duties may result in a direct violation of contractual and professional obligation.