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OIG, CMS or DOJ? Look at options before making self-disclosure

06/18/2018

If you’ve detected a pattern of overpayment or other malfeasances at your practice that could bring the attention of the feds, in addition to repaying or correcting the issue, you should self-disclose – but first choose carefully among the agencies that offer this option.

New Medicare cards in the mail; MBIs available through portal

06/18/2018

by: Roy Edroso

Watch out for new Medicare cards in your office: CMS confirms that it has started sending out the new cards with new Medicare beneficiary identifiers (MBIs), and some of your patients may have already received them.

Patient unlikely to get AWVs on MA home visits — but check

06/18/2018

by: Roy Edroso

Question: One of our patient’s Medicare Advantage plans is offering its members home visits by a nurse. The nurse performs many of the same services that patients receive with they see their primary care physician for an annual wellness visit (AWV). Do I have to worry that they’ll perform AWVs on my patients without telling me about it and cause confusion and lost charges when I try to bill them?

Final ICD-10-CM update for 2019 includes 38 more changes than proposed

06/18/2018

by: DecisionHealth staff

Providers will have a total of 473 code changes beginning Oct. 1, including 279 new codes, 143 revised codes and 51 deactivated codes, according to the final list of changes issued June 11 by the Centers for Disease Control and Prevention.

Obesity-counseling claims keep rising but high denial rates stick

06/18/2018

by: Richard Scott

Practices around the country are providing a greater number of obesity-counseling services, as the 307,000 claims of G0447 (Face-to-face behavioral counseling for obesity, 15 minutes) in 2016 indicate.

7 tips to correctly tap into time to report new, existing prolonged care codes

06/11/2018

by: Richard Scott

Your E/M office coding can get tricky when you base your level of service on time spent with the patient, but understanding when to use time thresholds, such as during counseling-based visits, will give your coding a boost — especially when tacking on prolonged services to your encounter codes.

Patient unlikely to get AWVs on MA home visits – but check

06/11/2018

by: Roy Edroso

Question: One of our patients’ Medicare Advantage plans is offering its members home visits by a nurse. The nurse performs many of the same services that patients receive with they see their primary care physician for an annual wellness visit. Do I have to worry that they’ll do annual wellness visits (AWV) on my patients without telling me about it and cause confusion and lost charges when I try to bill it?

7 tips to correctly tap into time to report new, existing prolonged care codes

06/11/2018

by: Richard Scott

Comprehensive Primary Care program misses spending mark but practices love it

06/11/2018

by: Richard Scott

The Comprehensive Primary Care (CPC) initiative failed to substantially bend the Medicare spending curve, according to a new report. But leaders on the ground remain bullish about the value-based program, which they say has positioned their practices for long-term success.

Orthopedic practice scores a win in challenge to CCI code pairs

06/11/2018

by: Laura Evans

It doesn’t cost anything to ask for a correction if you find a possible Medicare coding error. And, as a Syracuse orthopedic practice discovered, you may end up reversing a troublesome code restriction that has been in effect for more than a decade.

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