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Watch enforcement concerns after new challenge to vaccine mandate

02/21/2022

An amended complaint backed by more than a dozen states is seeking to overturn the Supreme Court’s ruling on the vaccine mandate for health care staffers and, while experts consider it a long shot, it could delay broader enforcement.

Refresh your understanding of CPT coding for radiology services

02/21/2022

by: Sarah Gould, CPC

From diagnostic radiology to bone and joint studies, the expansive field of radiology services — predominantly spanning the 70000 CPT series — contains many commonly used codes. Assess the latest radiology updates, including 2022 changes, to keep your claims reporting up to date.

Make sure your provider is the last one to sign the note

02/21/2022

by: Roy Edroso

Question: At our practice, the billers are often the ones to close the doctor’s note. While we read through the note for coding, we also correct spelling and make other staff aware of missing documentation or orders. We sign and date along with the doctor’s signature and date. Is this OK? Also, if our physician assistants are rendering providers and we bill under our surgeon’s national provider identifier (NPI), do both the physician assistant (PA) and the surgeon need to sign the note?

Prolonged service utilization showed major ups, downs over 3-year period

02/21/2022

by: Julia Kyles, CPC

The use of prolonged services had their ups and downs in recent years, showing sharp swings between 2018 and 2020, and the COVID-19 crisis did not appear to have a negative impact on all codes.

Check your numbers as Provider Relief Fund spigot keeps running

02/14/2022

by: Roy Edroso

The fourth phase of the Provider Relief Fund (PRF), originally planned to end in December, is still delivering payments to health care providers. The ongoing disbursement serves as a reminder to report your previous PRF payments and, if you want the feds to recalculate your most recent payment, make sure it’s worth an audit risk.

Urine drug testing settlements signal suspicious coding, documentation patterns

02/14/2022

by: Julia Kyles, CPC

State and federal prosecutors continue to extract sizable settlements from practices that allegedly submitted fraudulent claims for one type of service — urine drug tests (UDT).

Can I shift unvaccinated patients to telehealth? Experts say there’s a case

02/14/2022

by: Roy Edroso

Question: I read about a rheumatologist in Santa Fe restricting her patients who chose not to vaccinate against COVID-19 to telehealth because she considered their presence in the practice dangerous to her immunocompromised patients. Does this raise patient abandonment issues?

Limit psychological testing to approved providers

02/14/2022

by: Sarah Gould

Question: Which providers can perform and bill for psychological testing services described by CPT codes 96136-96139?

OIG audit targets excessive billing for genetic testing

02/14/2022

by: Sarah Gould

Between 2016 and 2019, Medicare payments to laboratories for genetic tests quadrupled from $351 million to $1.41 billion. This sharp increase in spending on genetic testing is likely linked to excessive and fraudulent billing, according to a recent Office of Inspector General (OIG) report.

Negative results: Urine drug test denials hold bad news for family practices

02/14/2022

by: Julia Kyles, CPC

CMS made its last major update to urine drug testing (UDT) codes in 2017, when it deleted three HCPCS codes for presumptive drug tests (G0477-G0479) and adopted three new CPT codes (80305-80307) that picked up the outgoing G codes’ descriptors.

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