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01/22/2024
After a long delay, the independent dispute resolution (IDR) process for providers engaged in No Surprises Act conflicts with payers came back online in December. But there are other changes - some live now, some coming soon Ñ that you’ll want to know about in case you need to use it.
01/22/2024
Prepare your schedulers and billers for questions about the copay for 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).
01/22/2024
The National Correct Coding Initiative (NCCI) released the 2024 NCCI Policy Manual in early December, effective January 1. In addition to more substantive changes from its 2023 counterpart, numerous changes included general word choice updates that appear throughout the manual.
01/22/2024
Question: I interpret recent CMS rulemaking that the RTM codes (98975, 98977, 98980 and 98981) are bundled in the global period if they are being performed for the same diagnosis and by the same provider who did the surgery. Am I reading that correctly?
01/22/2024
Question: A physician debrides a hyperkeratotic lesion on a patient’s left foot, second toe. During the same encounter, he performs a debridement of the five toenails. Which CPT codes and modifiers would be reported for this procedure?
01/22/2024
Regular comprehensive exams are among the few services for which all Medicare beneficiaries are eligible. While initial preventive physical examinations (IPPE) and initial annual wellness visits (AWV) remain mired in their pandemic-era utilization numbers, subsequent AWVs continue a strong recovery.

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