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Most specialists performing chronic care management services succeeded

09/12/2016

Dozens of specialties billed chronic care management (CCM) code 99490 in 2015, achieving a cumulative denial rate of 5.7% for the million-plus claims submitted.

2017 CPT changes affect moderate sedation, influenza vaccine, bunionectomy codes

09/08/2016

by: Laura Evans and Julia Kyles

As you page through your newly released 2017 CPT manual, the biggest change you’ll notice may be what’s missing: The list of more than 400 codes that were defined as including moderate sedation has been deleted from Appendix G.

E/M utilization flat in 2015 — but watch out for late baby boomers (Updated)

08/29/2016

by: Roy Edroso

A coming wave of Medicare-age beneficiaries with a strong interest in their own health care means you should expect an uptick in E/M claims over the next few years, despite recent small increases in E/M utilization shown by newly released Medicare data.

CMS seeking feedback on how to improve Open Payments program

08/29/2016

by: Marla Durben Hirsch

CMS seeks provider input to enhance the Open Payments program and update its reporting requirements.

Use a modifier to overcome bundled codes involving advance care planning

08/29/2016

by: Richard Scott

Question: I have a provider who is billing for CPT code 99497, which is advance care planning (ACP), and I’m receiving denials on some claims — but not others. For example, I get denied every time I bill 99497 with hospital code 99222. Yet my claims with 99232 go through successfully. Can you help?

The Stark Reality: Costly biller oversights, outdated fee schedules

08/29/2016

by: Stark Medical Auditing

Overcome billing errors with an inside look at the auditor's toolbox, including an investigation into laboratory services, fee schedule updates, IT system upgrades and more.

Wi-Fi can be OK – but keep security tight and watch 'public' Wi-Fi

08/29/2016

by: Roy Edroso

Question: Is our office Wi-Fi a HIPAA vulnerability when it comes to protected health information (PHI)?

NPPs billing of own office E/Ms increases while other specialties see drops

08/29/2016

by: Roy Edroso

Non-physician practitioners (NPPs) increased their billing of 99201-99215 in 2015, going up 17.4% for nurse practitioners (NPs) and 16.4% for physician assistants (PAs).

Negotiate for patient record access when rival practices close

08/22/2016

by: Roy Edroso

Increase your patient census and practice revenue when a nearby practice closes by striking a deal for limited access to patient records without paying for the privilege.

Avoid privacy pitfalls when a patient files for bankruptcy

08/22/2016

by: Marla Durben Hirsch

Pay close attention to what you send to court when you file a claim against a patient who is seeking federal bankruptcy protection. If you provide too much information, you can be liable for violating privacy rules established by the bankruptcy regulations, HIPAA and state law.

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