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How to hire, bill appropriately for temp providers and avoid lost payments

07/25/2016

It’s summer vacation time, so make sure your vacating providers are properly covered by locum tenens — whether they’re called that or not.

CCI edits: Shoulder debridement edits get deleted but restrictive CCI policy remains

07/25/2016

by: Laura Evans

Watch out for an inconsistency in Medicare and private payer billing policies that affects your practice’s shoulder coding.

Here’s how to code an endoscopic swallowing study in a facility

07/25/2016

by: Laura Evans

Question: My ENT physician has been providing flexible fiberoptic endoscopic examination of swallowing (FFEES) studies at a facility, mostly billing FFEES code 92616, and she has been doing the interpretation and report. Many of the patients are in an inpatient stay, and Medicare has not been reimbursing her for code 92616 because of place of service 21 (inpatient hospital). Can she just report the flexible laryngoscopy code 31575 used in providing the swallow study, since she does bring her own scope?

Family medicine, hematology expect gains in 2017 payments; others take cuts

07/25/2016

by: Richard Scott

Family practice, internal medicine and hematology/oncology providers are among 22 specialty groups that can look forward to an increase in allowed Medicare charges in 2017, while 14 groups will sustain payment cuts, according to the proposed 2017 Medicare physician fee schedule.

CMS proposes Medicare program for pre-diabetic patients, non-licensed coaches

07/18/2016

by: Roy Edroso

CMS is rolling out a service for pre-diabetic patients that you might want to consider as a case partner – or even as a service to take on board at your own practice.

CCM services: Eased billing rules await in 2017; new complex codes proposed

07/18/2016

by: Richard Scott

You’ll find less red tape to cut through when you report chronic care management (CCM) services in 2017, plus two additional active CCM codes next year, should CMS’ suggested changes go live as proposed.

CMS’ Slavitt tells Finance committee MIPS delay is ‘on the table’

07/18/2016

by: Julia Kyles

Don’t stop your quality payment program preparations. Even though CMS is considering “multiple approaches” to how — and when — it will launch the program, practices shouldn’t assume the agency will put the merit-based incentive payment system (MIPS) on hold.

Proposed G codes offer payment for psychiatric, care management, mobility-related services

07/18/2016

by: Richard Scott

You could find a slate of new reimbursement channels in 2017 when you provide certain behavioral health services to your patients as Medicare expands how it pays providers for the ongoing coordination of a patient’s care.

Surgeons will report visits during global period with G codes in 2017

07/18/2016

by: Laura Evans, CPC

Physicians who bill Medicare for the 4,200 surgical codes with 10- or 90-day global periods will have eight new unpaid G-codes to report next year for the visits and other services they provide during the global period, the agency announced in the proposed 2017 Medicare physician fee schedule.

Watch for new Medicare Advantage enrollment requirements, data sets

07/18/2016

by: Roy Edroso

CMS wants to require all providers and suppliers involved in Medicare Advantage services — including HMOs, Program of All-inclusive Care for the Elderly (PACE) and other organizations — to be enrolled in Medicare “in an approved status,” according to the proposed 2017 Medicare physician fee schedule.

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