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Want to banish burdens? Air your grievances, propose ideas to CMS now

06/24/2019

If you want to diminish the red tape you must cut through when participating in federal health care programs, you have until Aug. 12 to let CMS know what it can do to ease your administrative hurdles, such as onerous documentation.

Heed employee charges of patient harassment — but be careful about banning the patient

06/24/2019

by: Roy Edroso

Physician practices have a duty to protect their employees from sexual harassment by patients with clear reporting procedures and follow-through. But you may want to consider your options before telling the accused patient not to come back for treatment.

Claiming modifier 22? Make sure it’s extra work, then make your case

06/24/2019

by: Roy Edroso

Question: Our surgeon performed an acetabular fracture (27254) and it took him a great deal longer than usual owing to the patient’s obesity. He wants to use modifier 22 (Increased procedural services) to be paid for the extra time. What do we have to give CMS to get that paid?

Big operations (total knee, shoulder) do well with 22, but what’s with the heat lamp?

06/24/2019

by: Roy Edroso

Modifier 22 (Increased procedural services) doesn't get claimed a lot. But on some of procedures for which it’s most often used — the ones for which you can easily see how extra work would be required — it has low denial rates. And there are some codes with 22 for which you have to wonder what the billers were thinking.

Veterans get more non-VA health access via practices, urgent care

06/24/2019

by: Roy Edroso

The U.S. Department of Veterans Affairs (VA) has issued a pair of rules offering people who have served in the U.S. military opportunities for covered health care outside the 1,255 health care facilities specifically designated for veterans.

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