Announced in the Wall Street Journal on Dec 3, 2014, the Obama administration has strengthened Medicare’s authority to kick doctors and other medical providers out of the federal program for abusively billing the government.
Eligible professionals (EPs) who reported at least one PQRS quality measure during 2014 via claims-based reporting can access their data on a quarterly basis using the 2014 PQRS Interim Feedback Dashboard. The dashboard allows EPs to monitor the status of claims-based individual measures reporting to determine if they are meeting PQRS requirements.
The dashboard allows EPs to monitor the status of claims-based individual measures reporting to determine if they are meeting PQRS requirements.
Posted in: Medical Coding News and Recent Articles, Medical Coding and Billing, Medical Coding Audits and Compliance,
MBS), which agreed to pay $1.95 million to settle claims that it violated the False Claims Act by fraudulently changing diagnosis codes on claims to Medicare and Medicaid, in order to get the rejected claims paid on behalf of radiologists.
Centers for Medicare & Medicaid Services (CMS) recently finalized a rule which expands reporting options for the meaningful use EHR Incentive Program in 2014.
Posted in: Medical Coding News and Recent Articles,
Lynn Berry, PT, CPCPT, suggests that physical therapy (PT) providers should go to the website, put in their NPI numbers or names, and see where their Medicare billing stood in relation to other providers.
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.