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Check with your MAC on retroactive rollback of 59 Q1 CCI edits

02/24/2020

Take heart if you’ve been getting denials this year for therapy evaluations (97161-97172) when reported with one-on-one therapy activities (97530) or group therapy procedures (97150).

Court throws out fee policies for medical record sharing; watch for new rules

02/24/2020

by: Roy Edroso

A court ruling has obliterated the HHS guidance that requires your practice to charge third parties the same low price as patients for medical records.

CDC vaccination guidance reminds coders to stay diligent to minimize denials

02/24/2020

by: Jim Dresbach

Your clinic or office should take note of the revised immunization standards that the CDC and other medical organizations recently posted.

The ABCs of MUEs: Wrap in the latest service caps for correct billing in 2020

02/24/2020

by: Jim Dresbach

You’ll find a wide range of CPT and HCPCS codes that have been assigned medically unlikely edits (MUEs) this year, and it is imperative for you to know how to utilize the new information.

High immunization rates, low denials but elderly shy away from flu shots

02/24/2020

by: Jim Dresbach

The influenza vaccine remains at the fore of preventive medicine, yet reports support the notion that American adults are balking at this type of service.

Coronavirus fears at work: What employers need to know to stay protected

02/17/2020

by: Tammy Binford

News reports of deaths and illnesses from the rapidly spreading coronavirus get scarier every day. Millions of people are being quarantined. Foreign companies and governments are evacuating their people from hard-hit areas of China where the virus got its start. And even employees who don’t travel for work are getting anxious about traveling coworkers who may have been exposed.

After ‘historic’ acupuncture approval, weigh benefits of expanding your treatment arsenal

02/17/2020

by: James Dresbach

A new CMS position involving acupuncture and Medicare coverage is being called “historic” and “monumental” and will become a possible first step in reversing denial rates when billing and coding CPT codes 97810-97814.

Open Payments refresh brings in new categories, adds new provider types

02/17/2020

by: Roy Edroso

Heads up: Data submission to the Open Payments system has begun, and there have been some changes in who and what gets reported.

Repeating a test? Check with your MAC, use correct modifier and no do-overs.

02/17/2020

by: Roy Edroso

Question: We had to do a series of electrocardiograms (ECG) on a patient in the course of the same day. Is it appropriate to use modifier 76 (Repeat procedure or service by same physician) for this? Also, is 76 appropriate to use for other tests that are repeated for a patient?

Repeat modifier 76 works great in most cases – but sometimes wipes out

02/17/2020

by: Roy Edroso

Modifier 76 (Repeat procedure or service by same physician) is a pretty good bet in most cases, but there are a lot of codes for which it’s seldom or never accepted.

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