On December 3, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that will improve CMS’ ability to deny or revoke the enrollment of entities and individuals that pose a program integrity risk to Medicare.
This fact sheet summarizes CMS’ regulatory additi... Read More
Thanks to the over whelming positive feedback and support from our customers, we recently launched our new edition of our DRG-Grouper.
Same great classification and reimbursement methodologies, however we have made various cosmetic changes to the way our grouper looks and feels.... Read More
Joint DME MAC/PDAC Publication
The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have evaluated the MyoPro® upper extremity assist device and determined that it falls within the Durable Medical Equipment (DME) benefit category. Claims for MyoPro® should be submitt... Read More
What are NCDs and LCDs?
NCD — NATIONAL COVERAGE DETERMINATIONS
Medicare specific coverage on the national level. All Medicare carriers are required to follow the NCDs. The NCDs are developed by CMS to describe the circumstances for Medicare coverage nationwide for an item or service. NC... Read More
Medicare has established 5 new codes for reporting FQHC (Federally Qualified Health Center) services effective Oct 01, 2014. Very specific guidelines are to be followed for proper reimbursement.
G0466 — A medically-necessary, face to face encounter (one-on-one) between a new patie... Read More
I would recommend this without reservation to a new coder or student. Although students should still become familiar with their books and coding conventions for testing purposes, this online product is the first I have seen that so closely mirrors the indexes in books. You can easily narrow yo... Read More
In this electronic age, Social Media has quickly become a very successful tool used for advertising/marketing, communication of various topics and reaching readers and networks beyond our wildest dreams. These networks are often leading to various opportunities or other positive occurrences that we... Read More
Find-A-Code has posted the November 2014 edition of the Medicare Evaluation and Management Services Guide.Go to https://www.findacode.com/medicare/e-m-guidelines-manuals.html From the title page of the guide:
This guide is offered as a reference tool and does not replace cont... Read More
CMS will begin applying the Value Modifier in calendar year (CY) 2017 to all physicians; including those in groups with two or more eligible professionals (EPs), and to physicians who are solo practitioners. This policy completes the phase-in of the Value Modifier to all physicians and groups of phy... Read More
Medical expenses are one of the largest expenses in many United States households. Medical bills and insurance remittance are also possibly the most difficult of all bills for patients to interpret and understand.
Of course, this lack of understanding often has a negative impact on many... Read More