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A new CMS position involving acupuncture and Medicare coverage is being called “historic” and “monumental” and will become a possible first step in reversing denial rates when billing and coding CPT codes 97810-97814.


Question: We had to do a series of electrocardiograms (ECG) on a patient in the course of the same day. Is it appropriate to use modifier 76 (Repeat procedure or service by same physician) for this? Also, is 76 appropriate to use for other tests that are repeated for a patient?


Heads up: Data submission to the Open Payments system has begun, and there have been some changes in who and what gets reported.


Modifier 76 (Repeat procedure or service by same physician) is a pretty good bet in most cases, but there are a lot of codes for which it’s seldom or never accepted.


News reports of deaths and illnesses from the rapidly spreading coronavirus get scarier every day. Millions of people are being quarantined. Foreign companies and governments are evacuating their people from hard-hit areas of China where the virus got its start. And even employees who don’t travel for work are getting anxious about traveling coworkers who may have been exposed.


If the news that Medicare will cover acupuncture for chronic low back pain piqued your interest, review the guidelines for dry needling and acupuncture codes.


HHS announced Jan. 31 the novel Coronavirus virus – aka 2019-nCoV – that went epidemic in the Hubei province of China last year and has since been detected in a handful of cases here constitutes a public health emergency in the U.S. This is a cue for you to check and, if necessary, tighten infection control in your office.

You’re probably elbows-deep in your ICD-10 transition prep as we speak, but take a moment to review a few points about the transition that experts say may be eluding even the most conscientious practice managers: 
Don’t count on the advance payment option. CMS brought up in its recent FAQs the possibility of advance payment on claims held up by ICD-10-related snafus. “If the Part B Medicare administrative contractors (MACs) are unable to process claims within established time limits because of administrative problems, such as contractor system malfunction or implementation problems, an advance payment may be available,” CMS said in FAQ No. 18.  “Physicians would be allowed to submit a single advance payment request for multiple claims for an eligible period of time.”
But advance payments will be available only if Medicare’s systems fail, points out Michelle Cavanaugh, an AHIMA-approved ICD-10 trainer and RCM manager for electronic health record (EHR) vendor Kareo in Irvin, Calif. “The prepayment request will not be available for the provider who is not prepared or whose software vendors are not ready to send ICD-10 claims. This is not a safety net.”
Don’t get caught up in wishful thinking. Advance payment remains what it has always been – a remedy for CMS’ screw-ups, not yours (PBN 6/16/08).
Click here to read the full story.
As practices find expanded coverage of Next Generation Sequencing tests, two CPT codes used most frequently — 81432 (Genomic sequencing procedures and other molecular multianalyte assays) and 81445 (Targeted genomic sequence panel, neoplasm, 5-50 genes) — are on divergent paths.
New, expansive requirements for reporting providers accused of sexual misconduct have become law in California, suggesting that the trend presaged by #MeToo could require practices to step up their reporting in other states as well. 
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