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Watch locum tenens contract terms to guard against rogue providers

04/28/2025

A traveling nurse convicted of tampering with morphine raises the question: How responsible is your practice for outside clinical providers hired on a freelance basis?

Hefty telemedicine correction adds opportunity, also restricts billing

04/28/2025

by: Julia Kyles, CPC

Download the latest set of technical corrections from the AMA and be ready to share relevant sections when you appeal denials of your telemedicine services (98000-98016).

Defend your psychotherapy revenue from the top down

04/28/2025

by: Julia Kyles, CPC

Whether your practice specializes in psychiatric services or wants to add a specialist to your practice, you must know what’s required for commonly reported services. Your research should start with who performs the services.

Oz, AI and MA: Signs point to more AI, sooner, for CMS

04/28/2025

by: Roy Edroso

Lately CMS has shown an interest in advancing its use of artificial intelligence (AI) in health care — possibly shading more into clinical use. But experts say there are still red lines that even this go-fast administration wouldn’t be likely to cross.

Appending XS instead of 59 returned favorable denial rates

04/28/2025

by: Richard Scott

Practices that turned to the “separate structure” modifier XS in place of modifier 59 found greater success in their claims approval rates across a variety of services.

Nearly 500 new ICD-10-CM codes proposed for Oct. 1

04/21/2025

The proposed ICD-10 code changes — released with the FY2026 Hospital Inpatient PPS (IPPS) proposed rule on April 11 — include a new code for type 2 diabetes mellitus in remission, more than 100 new codes to capture non-pressure chronic ulcers in various stages as well as new codes for malignant inflammatory neoplasms.

Generous rate increase aids MA plans — but will it help providers?

04/21/2025

by: Roy Edroso

After a lean year under the Biden administration, Medicare Advantage (MA) plans got a big payday in the 2026 final MA rate notice. There’s good news for them in a recent final rule, too.

Skin deep: Accurately code, document skin lesion excisions and repairs

04/21/2025

by: Betty A. Hovey, BSHAM, CCS-P, CDIP, CPC, COC, CPMA, CPCD, CPB, CPC-I

Gain a detailed overview of coding guidelines for excisions and repairs to ensure that you correctly report these procedures.

CMS makes it official: Now more MA than Medicare FFS enrollees

04/21/2025

by: Roy Edroso

A recent slowdown in its rate of growth notwithstanding, the latest CMS figures show Medicare Advantage has overtaken traditional fee-for-service (FFS) Medicare in enrollment.

Short-term closing? To-do list includes emails to patients, call to counsel

04/14/2025

by: Roy Edroso

In case your practice suffers a temporary closure due to an accident or emergency, have on hand a list of the parties you will need to contact and the questions you will need to ask.

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