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Big operations (total knee, shoulder) do well with 22, but what’s with the heat lamp?

06/24/2019

Modifier 22 (Increased procedural services) doesn't get claimed a lot. But on some of procedures for which it’s most often used — the ones for which you can easily see how extra work would be required — it has low denial rates. And there are some codes with 22 for which you have to wonder what the billers were thinking.

Veterans get more non-VA health access via practices, urgent care

06/24/2019

by: Roy Edroso

The U.S. Department of Veterans Affairs (VA) has issued a pair of rules offering people who have served in the U.S. military opportunities for covered health care outside the 1,255 health care facilities specifically designated for veterans.

Change mindset, and maybe chairs, to avoid alienating obese patients

06/17/2019

by: Roy Edroso

The growth of obesity in our society has naturally led to a growth in obese patients — and in sensitivities that should be addressed lest these patients lose faith in and even stop coming to their providers for help. Fortunately, this isn’t hard to do: It mainly requires for some providers a change in attitude and some small adjustments in office procedures — and maybe furniture.

Shared Savings now heavier lift for providers; prep more or go with easier new models

06/17/2019

by: Roy Edroso

As another Shared Savings application process starts, accountable care organizations (ACO) and wannabe-ACOs that have considered joining at some point should review their readiness to take on the increased levels of risk in that program. Or they may consider other models that may be more appropriate for them.

CCI bundles wrap up E/M codes, substance-abuse screening and more

06/17/2019

by: Richard Scott

Give your billing staff a heads up: You’ll find nearly 1,900 new procedure-to-procedure edits in the latest Correct Coding Initiative (CCI) update, which takes effect July 1. The quarterly update also revises the total unit count you can report per day for about 60 services, including X-rays and lesion-removal codes.

Hip X-rays remain most common extremity test but MRIs take top dollar

06/17/2019

by: Richard Scott

Providers report several million claims for hip, foot and shoulder X-rays every year but those services don’t pay out the most.

As more patients get their records, tailor notes to make them user-friendly

06/10/2019

by: Roy Edroso

New evidence strongly suggests that access to patient records improves patient treatment — which is your cue to take action and get your patients to not only access those records but also put them to good use.

Avoid a costly incident: 4 tips to thwart incident-to billing mistakes

06/10/2019

by: Richard Scott

Consider a recent investigation from the OIG a cautionary tale about a slice of Medicare billing — incident to — that often proves challenging for physician practices.

Proposed rule would affect required language services, trans treatment

06/10/2019

by: Roy Edroso

A new proposed rule from HHS and its Office for Civil Rights (OCR) reduces providers’ reporting burden on language accommodations for non-English-speaking patients — and seems to strip transgender patients of the protections afforded them by a previous rule.

Watch your remittance advice codes for MIPS payment gains, losses

06/10/2019

by: Richard Scott

Now that payment adjustments are in full swing under the federal Merit-Based Incentive Payment System (MIPS), you are likely to see new remittance advice remark codes (RARCs) on your Medicare claims. Paying attention to the remark codes means you can start keeping stock of your MIPS-related winnings and losses.

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