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Fight modifier 24 denials with this cover letter

12/08/2014

Manny Oliverez, CEO of Capture Billing in South Riding, Va., swears by a cover letter his billers use on claims with the problematic 24 modifier, along with good documentation.

Denial rates with modifier 24 highest among podiatrists, urologists

12/08/2014

by: Roy Edroso

General surgery and orthopedic surgery are among the top 10 specialties in which modifier 24 denials occur, but they aren’t the leaders: Podiatry, urology and dermatology outpace them in denial rates.

CMS official at AMA Symposium: Bill CCM on last day, use any POS

11/24/2014

by: Roy Edroso and Laura Evans

For monthly chronic care management (CCM) services, practices should bill the claim on "the last day of the calendar month for which the CCM service is billed," according to a senior CMS official.

Steep Medicaid rate cuts loom over practices in most states as federal funds set to expire

11/24/2014

by: Richard Scott

For many providers, Medicaid reimbursement rates are set to take a nosedive come 2015, and physician practices are being advised to plan accordingly.

Harness these 7 tips to gain a return on investment for meaningful use objectives

11/24/2014

by: Richard Scott

Attesting to meaningful use is not without its labor pains, but physician practices that meet the program’s core objectives can save hundreds of dollars every month and better engage their patient populations.

For endoscopic procedures, key to billing a separate E/M is often timing

11/24/2014

by: Scott Kraft

Whether you are billing for a laryngoscopy with 31510, a colonoscopy with 45378 or a nasopharyngoscopy with 92511, a quick check of the CCI edits will find that each has an E/M service bundled into it, so it’s important to know the factors determining when you can bill a seperate E/M.

Work with outside practitioners, patients to head off value-modifier cut

11/24/2014

by: Roy Edroso

CMS’ judgment on your patients’ care — and your reimbursement for it — is increasingly based on care your patients receive outside of your office. To keep from losing reimbursement you’ve earned, look at your quality reporting scores and start outreach to patients and care partners.

CMS elects not to finalize proposed DME fitting requirements

11/24/2014

by: Laura Evans

Orthopedic practices and their staff members that fit custom orthotics in the office will not be required to adhere to a tough new “specialized training” requirement for those services, proposed in July by CMS.

Medicare revises the additional documentation timeline

11/24/2014

by: Julia Kyles

Providers under pre-payment review by a Medicare contractor or zone program integrity contractor will have 45 calendar days to submit additional documentation, effective April 1, 2015.

CMS amends final rule affecting physician-owned hospital expansion requests, allows first expansion

11/24/2014

by: Marla Durben Hirsch

The amended rule, published Nov. 10 as part of the Outpatient Prospective Payment System Rule for 2015, among other things increases notification requirements and community input and allows additional data sources.

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