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CCI update: Be wary of modifier 59, cerumen removal, other coding pitfalls

12/12/2016

Audiologists should exercise caution when reporting lower-level cerumen-removal code 69209, and physicians delivering pulmonary services should heed episode-of-care guidelines, instructs the 2017 update to the National Correct Coding Initiative’s (CCI) policy manual.

Out-of-network doctors’ obligations grow under state ‘surprise billing’ laws

12/12/2016

by: Marla Durben Hirsch

When you aren't contracted with a particular insurer, be prepared to disclose that fact to patients before you treat them. States are beginning to enact laws against “surprise billing” by requiring doctors to be up front about their out-of-network status and providing patients with cost estimates.

2017 OIG Work Plan adds E/M, financial relationships to the watch list

12/12/2016

by: Julia Kyles

Providers who offer chronic or transitional care management services should take note of the latest Work Plan from the HHS Office of Inspector General (OIG). These services are two of the six new Work Plan targets that are likely to impact physicians and non-physician providers who bill Medicare Part B.

Temporary injunction stops Labor’s OT rule from taking effect nationwide Dec. 1

12/12/2016

by: Josh Poltilove

Practices that already increased employees’ salaries to avoid a new federal requirement to pay them overtime beginning Dec. 1 should examine whether that decision still makes sense.

New hospitalist specialty code debuts in April

12/12/2016

by: Roy Edroso

Watch out for a new specialty code for hospitalists going online for dates of service on or after April 1, 2017.

Amid billing quirks, providers ride wave of denials for cerumen-removal code

12/12/2016

by: Richard Scott

Providers are riding an up-and-down wave of denials related to ear wax removal code 69210 (Removal of impacted cerumen requiring instrumentation, unilateral), a common service that providers billed more than 1.6 million times in 2015.

Trump taps Obamacare foe Tom Price to lead HHS, Seema Verma to head CMS

12/05/2016

by: Richard Scott with additional reporting by Josh Poltilove and Burt Schorr

The direction of major health care programs, from insurance exchanges to Medicaid expansion, may be a step closer to course reversal after President-elect Donald Trump tabbed new leaders for two key federal posts.

Trump era likely will increase collections from patients but won’t end MACRA

12/05/2016

by: Roy Edroso

Beyond repeal of the Affordable Care Act (ACA), the incoming Trump administration may change health care policy in ways that will directly impact your practice — particularly if health savings accounts (HSAs) are tapped as an alternative.

7 coding tips for 2017: Find success with a coding roadmap

12/05/2016

by: Richard Scott

Prepare to kick off the new year with a bang by taking stock of new codes for care management, behavioral health and preventive services and getting ready to overcome wrinkles to some core services, such as mammography.

Report telehealth with new place of service code, expect facility fee for payment

12/05/2016

by: Julia Kyles, CPC-A

Include place of service code 02 (The location where health services and health-related services are provided or received, through telecommunication technology) on claims for telehealth services submitted on or after Jan. 1, 2017, to avoid denials.

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