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In surprise, AWV, IPPE use goes up, denials go down — even with 25

05/01/2017

The historically high denial rates on initial preventive physical examination (IPPE) and annual wellness visit (AWV) codes have seen a slight dip — even when billed with modifier 25 (Significantly, separately identifiable E/M service), commonly used when the physical results in a procedure.

Use these 6 tips to clear up allergy coding, reclaim lost revenue

04/24/2017

by: Richard Scott

As spring and its yearly influx of allergens arrive, get ready to trim your allergy coding denials with a plan that incorporates strict unit reporting and code-bundle adherence.

Proposed ICD-10-CM code changes put a lot of skin in the game

04/24/2017

by: Julia Kyles and Laura Evans

You’ll have a manageable set of diagnosis code changes on Oct. 1 — a total of 406 new, revised and deleted codes — and providers who code non-pressure chronic ulcers will receive the bulk of the new codes in the form of 72 new diagnoses that fill in the blanks for ulcers without evidence of necrosis.

Market stabilization final rule a mixed bag for practices; HHS cuts may hurt

04/24/2017

by: Roy Edroso

Here are the latest policy updates from the nation’s capital on the Trump administration’s attempt to shore up the Affordable Care Act (ACA) marketplace and how cuts will be applied to HHS.

‘Virtual’ version may make Medicare diabetes program more attractive

04/24/2017

by: Roy Edroso

The opportunity to get reimbursed for the upcoming Medicare Diabetes Prevention Program (MDPP) — which may be conducted by non-providers and with low overhead — may be easier for your practice if you obtain CDC recognition for an online version of the program or partner with a provider that has already done so.

Here’s how to know whether CAHPS, Web interface MIPS methods will work for you

04/24/2017

by: Roy Edroso

If you have high quality scores or are an accountable care organization (ACO), the Consumer Assessment for Healthcare Providers and Systems (CAHPS) or web interface reporting methods for the merit-based payment incentive system (MIPS) could make quality reporting easier.

Stick to the same DOS when adding up non-face-to-face prolonged care

04/24/2017

by: Richard Scott

Question: When using the newly covered non-face-to-face prolonged service codes (99358, 99359), can you bill them with time that has been accumulated over several dates of service? I’m asking because this seems very conceivable from a clinical perspective.

Lab-code denial rates may augur increased scrutiny from auditors

04/24/2017

by: Richard Scott

You’ll find sky-high improper payment rates for several groupings of lab codes spanning glucose testing, urinalysis, blood counts and others, according to CMS data from the 2016 Improper Payments Report.

Review 9 rules for ABNs as you prepare to use the renewed form

04/17/2017

by: Julia Kyles

Get ready to switch to the new advance beneficiary notice of noncoverage (ABN), and use the new form as an opportunity to go over the ABCs of ABNs with administrative and clinical staff.

Take note of wound-therapy billing changes after hyperbaric oxygen edit

04/17/2017

by: Richard Scott

Watch your Medicare administrative contractor (MAC) for instructions about how to bill the topical application of oxygen when treating chronic wounds after Medicare revised its national coverage determination (NCD) on hyperbaric oxygen therapy.

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