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Question: We have three follow-up questions about the new local coverage determination (LCD) for trigger point injections (20552-20553) that will take effect on April 1. ... More

NPP Report

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

The most recent CMS numbers show Medicare Advantage enrollment continuing to outpace traditional Medicare, and some measures suggest Part C has already beat fee-for-service Medicare to become the majo... More

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Question: We have three follow-up questions about the new local coverage determination (LCD) for trigger point injections (20552-20553) that will take effect on April 1. ... More

NPP Report

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

The most recent CMS numbers show Medicare Advantage enrollment continuing to outpace traditional Medicare, and some measures suggest Part C has already beat fee-for-service Medicare to become the majo... More

Breaking: More than 250 new ICD-10 codes proposed for Oct. 1

by: Megan Herr and Julia Kyles, CPC

Conversion factor update: New $33.2875 fee reflects 9-month boost

by: Julia Kyles, CPC

Latest on Change Healthcare hack: Part B providers not offered advanced payments, must seek alternative recourse

by: Roy Edroso

Give providers an illustrated guide to the new SDOH risk assessment code

Make sure your physicians and qualified health care professionals (QHP) are ready for their crucial role in reporting G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment tool, 5-15 minutes, not more often than every 6 months).

Cultivate Medicare prolonged service rule compliance with a decision tree

Use this decision tree to illustrate Medicare’s rules for coding prolonged E/M services. Medicare created codes and rules for prolonged services performed by a physician or qualified health care professional (QHP) because it disagrees with portions of the CPT guidelines.

FFS Medicare fades, as Medicare Advantage surges in enrollment

The most recent CMS numbers show Medicare Advantage enrollment continuing to outpace traditional Medicare, and some measures suggest Part C has already beat fee-for-service Medicare to become the majority Medicare insurer.

Active status for Category III codes doesn’t lead to active billing

CMS lists most Category III — or temporary — codes as carrier-priced. That means that each Medicare administrative contractor (MAC) will decide whether it will pay for a service on a case-by-case basis. In recent years the agency has granted active status to a few temporary codes, but a look at early Medicare Part B claims data shows that active status doesn’t generate a lot of buzz.

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