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 is establishing four new HCPCS modifiers to define subsets ofthe - 59 modifier, a modifier used to define a "Distinct Procedural Service."
Posted in: Medical Coding and Billing, Medical Coding Questions, Provider Documentation Training | Medical Coding Best Practices,
The AMA states that there are over 500 changes to the 2015 CPT code system.
Posted in: Medical Coding and Billing, Medical Practice Revenue Optimization, Provider Documentation Training | Medical Coding Best Practices,
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.”
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.
Recognize new coding conventions and brush up on your anatomy for proper ICD-10 coding.
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.
Even if you've been filing Medicare claim form 1500 for years, effective April 1, 2014 your process is about to change.
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.
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.