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Amid billing quirks, providers ride wave of denials for cerumen-removal code

12/12/2016

Providers are riding an up-and-down wave of denials related to ear wax removal code 69210 (Removal of impacted cerumen requiring instrumentation, unilateral), a common service that providers billed more than 1.6 million times in 2015.

Trump taps Obamacare foe Tom Price to lead HHS, Seema Verma to head CMS

12/05/2016

by: Richard Scott with additional reporting by Josh Poltilove and Burt Schorr

The direction of major health care programs, from insurance exchanges to Medicaid expansion, may be a step closer to course reversal after President-elect Donald Trump tabbed new leaders for two key federal posts.

Trump era likely will increase collections from patients but won’t end MACRA

12/05/2016

by: Roy Edroso

Beyond repeal of the Affordable Care Act (ACA), the incoming Trump administration may change health care policy in ways that will directly impact your practice — particularly if health savings accounts (HSAs) are tapped as an alternative.

7 coding tips for 2017: Find success with a coding roadmap

12/05/2016

by: Richard Scott

Prepare to kick off the new year with a bang by taking stock of new codes for care management, behavioral health and preventive services and getting ready to overcome wrinkles to some core services, such as mammography.

Report telehealth with new place of service code, expect facility fee for payment

12/05/2016

by: Julia Kyles, CPC-A

Include place of service code 02 (The location where health services and health-related services are provided or received, through telecommunication technology) on claims for telehealth services submitted on or after Jan. 1, 2017, to avoid denials.

Revised list of Stark designated health services swaps old codes for new

12/05/2016

by: Julia Kyles, CPC-A

Medicare’s final 2017 physician fee schedule includes an annual update of changes to codes that constitute four categories of designated health services under the Stark physician self-referral rule.

Providers billed millions of mammography claims with codes set for deletion

12/05/2016

by: Richard Scott

Pay close attention to your mammography coding in 2017 because several deleted codes and a delay in CMS payment processing means you’ll need to shift to current HCPCS codes to ensure you gain reimbursement.

Will Trump end the ACA? Some practices approve; experts say not so fast

11/21/2016

by: Roy Edroso

Practices are optimistic that President-elect Donald Trump’s promised quick repeal of Obamacare will improve their fortunes and their patients’ options, according to 85 respondents of a recent Part B News survey. But experts warn that the changes, whatever they may be, will probably come slower than expected.

Navigate historical vs. current diagnoses to gain the risk-adjustment upper hand

11/21/2016

by: Richard Scott

Be on the lookout for common problem areas in your risk-adjustment coding, such as “history of” diagnoses, to ensure you’re achieving correct risk scores — and fair payment.

CMS attributes patients to specialties based on E/M volume, NPPs’ work

11/21/2016

by: Julia Kyles, CPC

Specialists who are facing a value-based modifier cut because they were ranked as high cost in 2015 should take a close look at how patients were attributed to them and act now to avoid a repeat cut based on their 2016 performance.

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