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Benchmark of the Week
10/21/2019
When reporting a series of oft-used psychotherapy services (90832-90838), providers tend to stick to a pattern of long-duration standalone codes and shorter-duration add-on codes.
10/14/2019
The utilization of complex chronic care management (CCM) code 99489 increased more than 285% between 2017 and 2018, as practices appeared to embrace longer-lasting care management episodes.
10/07/2019

Medicare has published its 2018 patient claims data, which shows a pretty smooth rise in spending for total claims — and a bit of a spike for established patient office E/M code 99214.

09/30/2019

     When delivering common injection and procedure services, providers tend to veer to the right side of the body more often than the left. That’s what an inspection of claims with RT (Right side) and LT (Left side) modifiers reveals.
09/30/2019
When delivering common injection and procedure services, providers tend to veer to the right side of the body more often than the left. That’s what an inspection of claims with RT (Right side) and LT (Left side) modifiers reveals.
09/23/2019

Auditors emphasize the amount of improper payments attributed to common venipuncture code 36415 with bundled codes in 2018. But it’s also worth noting that the codes with which 36415 may have been improperly claimed generally pay more — and it’s really not worth potentially gumming up your claims on those codes for a small extra payment on a blood draw.

09/16/2019
Alert your billing staff to several dozen code bundles that will restrict a range of same-day services, including some allograft procedures, when the latest Correct Coding Initiative (CCI) edits take effect Oct. 1.
08/26/2019
Practices are expecting to take a hit on cataract surgery fees in 2020 based on pay rates announced in the proposed 2020 Medicare physician fee schedule, and that could lead to a drain of hundreds of millions of dollars nationally.
08/19/2019

If the codes CMS just cleared to be billed with transitional care management (TCM) in 2020 see a lift in utilization, you can be pretty confident that clearance will be the reason for the change. That's because, as you can see by this chart, utilization of these codes over the past five years has been very consistent — and mostly low — even when payment terms have been altered.
 

08/12/2019
Cue the drum roll: After analyzing the numbers and poring over the inputs, a Part B News analysis turned up some big winners and unfortunate losers from the proposed 2020 Medicare physician fee schedule.

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