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Large pay gains tied to greater advance care planning activity in 2017

10/01/2018

Claims for advance care planning codes 99497-99498 increased significantly between 2016 and 2017, topping out at nearly 1.3 million services collectively, according to the most recent Medicare claims data.

Track patient population, negotiate prices and waste less flu vaccine this fall

09/24/2018

by: Roy Edroso

To make your flu season vaccination plan a successful one — and not a waste of your patients’ time and your practice’s money — plan your ordering and administration of the vaccine and follow a few simple rules.

ICD-11 is here and U.S. is mulling its use for mortality reporting

09/24/2018

by: Laura Evans, CPC

As coders mark the third anniversary of the U.S. adoption of ICD-10 this October, its newly minted successor is waiting in the wings, nearly ready for adoption.

Avoid specimen validity, drug screen codes on same day except in rare cases

09/24/2018

by: Richard Scott

Refrain from reporting specimen validity testing when you perform drug screens using a batch of common CPT and HCPCS codes or you may wind up in the crosshairs of CMS auditors and HHS’ Office of Inspector General (OIG).

5 tips to cut denials on intensive counseling for obesity (G0447)

09/24/2018

by: Richard Scott

Make sure you hit the mark on various coding rules, such as weight measures and reporting frequency, to successfully report intensive behavioral therapy services for patients who could benefit from trimming their waistlines.

Avoid anatomic modifiers on unlisted surgical codes to stay within coding bounds

09/24/2018

by: Richard Scott

Question: Can you please provide advice about reporting modifiers with unlisted codes? We are using modifiers 50, 62, 82, RT and LT to communicate to the carrier that the unlisted procedure we are billing is being done bilaterally at times with an assistant surgeon or co-surgeon. However, CPT has expressed this is incorrect. Is there a hard-and-fast rule on using modifiers with unlisted CPT codes?

Unlisted codes a poor bet for success, especially if you miss a memo

09/24/2018

by: Roy Edroso

Providers don’t like to use unlisted codes if they can help it, and no wonder — the denial rates are ridiculous.

Human trafficking victims: Know the signs and what to report

09/17/2018

by: Marla Durben Hirsch

Your practice should be up to speed on your obligations involving human trafficking. Odds are that you’ve probably treated a human trafficking victim— even if you didn’t realize it.

Signs that a patient may be a victim of human trafficking

09/17/2018

by: Marla Durben Hirsch

It’s often difficult to discern whether a patient is a victim of human trafficking. Check for these signs.

CCI edits bundle biopsy codes, revise prolonged service billing caps

09/17/2018

by: Richard Scott

Alert your billing staff to the latest Correct Coding Initiative (CCI) edits, which add 942 new code bundles mostly targeting surgical codes across a range of CPT and HCPCS families. Effective Oct. 1, the CCI version 24.3 update also brings nearly 150 revised medically unlikely edits (MUEs), which change established service-unit caps.

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