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Benchmark of the Week
04/23/2018
Claims for transitional care management (TCM) codes 99495-99496 are up and denials are down, but the rising tide is not lifting some specialties (like neurosurgery) nor some places of service (like inpatient hospitals).
04/16/2018

Use the latest comparative billing report (CBR) to determine whether your practice’s clinicians may be flagged for a higher-than-average prescribing pattern.

04/09/2018
The most frequently reported physical therapy code, 97110 (Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility), topped $1.1 billion in payments in 2016, the latest year of available Medicare claims data.
04/02/2018

An AMA survey of 1,000 practicing physicians finds that prior authorization for medical services isn’t just annoying for them — it’s possibly a net loss for their patients’ health.

03/26/2018
Despite Medicare’s decision to no longer cover a suite of five outpatient consultation codes (99241-99245) nearly a decade ago, providers continue to pursue a mission impossible and seek payment for thousands of visits per year.
03/19/2018

Use of codes related to sleep apnea and continuous positive airway pressure (CPAP) continues to grow, but denial rates show providers have to be careful.

03/12/2018
Clinical psychologists outpaced other specialists when reporting cognitive-training code 97532, now deleted, yet all reporters, including occupational therapists and primary care providers, should take note of CMS’ guidance to use HCPCS code G0515 (Development of cognitive skills to improve attention, memory, problem solving [includes compensatory training], direct [one-on-one] patient contact, each 15 minutes) in its place in 2018.
03/05/2018
The five CPT knee X-ray codes have relatively low denial rates – except for a bit of mayhem with the two least-used codes.
03/05/2018

The five CPT knee X-ray codes have relatively low denial rates — except for a bit of mayhem with the two least-used codes.

02/26/2018
The difficulties attached to getting Medicare to pay for telehealth services — the originating-site and sometimes geographical restrictions — are evident in the low utilization for the codes specifically dedicated to telehealth. But some of the denial rates are low and, if hints from CMS mean what they seem, the codes may see more use in years to come.

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