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Diabetes training, E/M on same day OK if you bill with different NPIs

03/14/2016

Question: If a patient is receiving diabetic self-management training (DSMT), can they also receive an E/M service related to diabetes on the same day?

5 reasons to think twice about providing free treatment for employees

03/14/2016

by: Roy Edroso

If you want to provide free medical treatment as a perk to your employees, be careful to spell out the limits of the benefit up front.

Use of initial AWVs keep going down — but denial rates keep going up

03/14/2016

by: Roy Edroso

Denial rates for the initial annual wellness visit (AWV) are on the rise, which may help explain why their use is going down. Subsequent AWVs, however, are improving in both utilization and denials.

Annual Wellness Visit form includes key screenings

03/14/2016

by: Roy Edroso

Click the "Download file" link to access an annual wellness visit (AWV) form updated for 2016 with new screenings.

Code new spine, hip and pelvis X-ray codes based on number of views

03/07/2016

by: Laura Evans

New X-ray codes for spine, hip and pelvis in the 2016 CPT manual are meant to simplify coding of those imaging services, but already the new codes are raising uncertainty among coders about their use.

Reduce misconduct allegations, liability by using medical chaperones

03/07/2016

by: Marla Durben Hirsch

Assess whether your practice should start using or increase use of medical chaperones when examining patients. More patients than ever are filing complaints against physicians for inappropriate behavior during exams, and having a chaperone goes a long way to deter and defend against such allegations.

Use judgment, probe audits, documentation as new rule tightens overpayments

03/07/2016

by: Roy Edroso and Marla Durben Hirsch

Be scrupulous — within reason — when you’re tipped off to a possible overpayment, as a new final rule lowers the bar for what can put you in danger of serious penalties. Also, be aware that you may have more than 60 days from discovery to return the money.

Heed pulmonary-testing code updates to trim denials, capture reimbursement

03/07/2016

by: Richard Scott

Clear an unobstructed path to reporting common pulmonary function and inhalation treatment tests by avoiding bundled codes and correctly attaching modifiers — and leave those denials gasping for air.

No EHR? No problem. Avoid MU penalties for 2015 by filing a hardship exception

03/07/2016

by: Richard Scott

Question: We don’t currently work out of an electronic health record (EHR). Would we qualify for the hardship exception or is it for those eligible professionals (EPs) that are actually using an EHR and can’t attest?

Primary care, specialty docs see rising denials on core pulmonary tests

03/07/2016

by: Richard Scott

Primary care physicians had a difficult time getting their claims through for spirometry code 94010 (Measurement and graphic recording of total and timed exhaled air capacity) and two other pulmonary-testing codes that practices billed frequently in 2014, the most recent year of available claims data.

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