TCN Medical Coding Blog

Radiology Billing Company To Pay $1.95 Million To Resolve False Claims Act Allegations

Oct 16, 2014
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.

New meaningful use rule: MGMA and CMS offer resources

Sep 20, 2014
Centers for Medicare & Medicaid Services (CMS) recently finalized a rule which expands reporting options for the meaningful use EHR Incentive Program in 2014.

Physical Therapy Providers - The OIG Might Want to Look at Your Records Too

Sep 20, 2014
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.

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.