Part B News
CMS releases Moderna booster codes after FDA approval
05/02/2022
by: Richard Scott
As the COVID public health emergency endures, you’ll find a new code that you can report when providing a Moderna booster shot, along with a complementary administration code.
Didn’t get discharge data? Sorry, you can’t charge TCM
05/02/2022
by: Roy Edroso
Question: We performed transitional care management (TCM) on a patient who had been discharged as an inpatient by a provider from a different practice. When our claim went in, the payer did not have the discharge summary on file and denied our claim. What can we do?
Turn to Q codes, modifier JW for discarded CTP products
05/02/2022
by: Sarah Gould, CPC
Question: How do you code and bill for wound debridement involving the disposal of unused cellular-based tissue product (CTP)?
Behavioral health services continue to climb, revenue jumps
05/02/2022
by: Richard Scott
The growth of two services that Medicare has approved in recent years — cognitive assessment service 99483 and behavioral health care management code 99484 — signals that practices are spending more time addressing their patients’ behavioral health needs.
CMS’ revamped split/shared policy could jeopardize physician payments
04/25/2022
by: Julia Kyles, CPC
Watch out for a hidden hazard lurking behind Medicare’s new split/shared rule. Experts say it could lead to lower compensation for practices, and medical societies warn the new rule will also disrupt patient care.
ICD-10-CM proposals cover 1,100-plus new codes, scores of changes
04/25/2022
by: DecisionHealth Staff
Brain illness and injury, with a focus on dementia-related diagnoses, occupy a high volume of the 1,495 proposed changes to the ICD-10-CM code set announced April 18.
Explain incident-to with a decision tree designed for common errors
04/25/2022
by: Julia Kyles, CPC
Warn your physicians: Auditors and investigators will not be forgiving if they discover that your practice profited from incident-to billing errors.
7 areas of common OCR enforcement reveal risky compliance snags
04/25/2022
by: Matt Duffy
In January, the Office for Civil Rights (OCR) released its latest round-up of HIPAA “enforcement highlights,” and the years’ worth of data reveals weak spots for medical practices, covered entities (CE) and business associates (BA). Be mindful of how you disclose and safeguard protected health information (PHI) to avoid a breach.
In 2020, COVID fueled a year of ups and downs for ABNs
04/25/2022
by: Julia Kyles, CPC
Providers issued fewer advance beneficiary notices of non-coverage (ABN) during the first year of the COVID-19 public health emergency (PHE) than they had in previous years, even as two ABN modifiers grew in popularity.
Feds signal a PHE cease. Expect some waivers, like Stark Law, to go when it does.
04/18/2022
by: Roy Edroso
Signs are emerging that the national public health emergency (PHE) related to COVID-19 is entering an end phase, and practices should start planning for a halt to some of their PHE-based flexibilities, such as referral arrangements, that likely are not going to survive it.
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