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October 1st, 2019
Federal Workers Compensation Information
By Wyn Staheli, Director of Research | Published October 1st, 2019
When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program.
Division of Federal Employees' Compensation (DFEC) website
Division of Federal Employees' Compensation (DFEC) provider ...
CMS and HHS Tighten Enrollment Rules and Increase Penalties
By Wyn Staheli, Director of Research | Published October 1st, 2019
This ruling impacts what providers and suppliers are required to disclose to be considered eligible to participate in Medicare, Medicaid, and Children's Health Insurance Program (CHIP). The original proposed rule came out in 2016 and this final rule will go into effect on November 4, 2019.
There have been known problems ...
tags Specl: All Specialties Specl: Chiropractic Topic: Medicare
Spotlight: UCR Fees are Available on DRGs- Check it Out!
By Brittney Murdock, QCC, CMCS, CPC | Published September 17th, 2019
Check out the information page on any DRG! Look up DRGs by going to the list of DRG codes found under the Codes tab at the top of the page, or simply type in the desired DRG by using the search bar on the homepage.
When using the search bar, be sure you have the ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published September 16th, 2019
The new 2020 CPT codes are on the way! We are going to see 248 new codes, 71 deletions, and 75 revisions. Health monitoring and e-visits are getting attention; 6 new codes play a vital part in patients taking a part in their care from their own home. New patient-initiated ...
tags Topic: E+M Documentation and Coding Topic: Procedure Coding
Q/A: Is the Functional Rating Index by Evidence-Based Chiropractic Valid?
By Wyn Staheli, Director of Research | Published September 9th, 2019
Question
Is the Functional Rating Index, from the Institute of Evidence-Based Chiropractic, valid and acceptable? Or do we have to use Oswestry and NDI?
Answer
You can use any outcome assessment questionnaire that has been normalized and vetted for the target population and can be scored so you can compare the results from ...
Cranial nerves are involved with some of our senses such as vision, hearing and taste, others control certain muscles in the head and neck. There are twelve pairs of cranial nerves that lead from the brain to the head, neck and trunk. Below is a list of Cranial Nerves and ...
So How Do I Get Paid for This? APC, OPPS, IPPS, DRG?
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published August 21st, 2019
You know how to find a procedure code and you may even know how to do the procedure, but where does the reimbursement come from? It seems to be a mystery to many of us, so let's clear up some common confusion and review some of the main reimbursement systems. One of the ...
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published August 20th, 2019
Find-A-Code has created a TOPIC page specifically for Chiropractors. Check it out! We have simplified your search with Articles, Tips, Webinars, and Tools all in one place for your convenience.
Be sure to visit us today. Simply go to Findacode.com then hover over TOPICS at the top of the page, then select Chiropractic.
...
Are You Aware of Medicare Advantage Plans Timely Filing Rules?
By Aimee Wilcox | Published August 20th, 2019
The Medicare Fee for Service (FFS) program (Traditional or Original Medicare) has a timely filing requirement; a clean claim for services rendered must be received within one year of the date of service or risk payment denial.
As any company who has billed Medicare services can attest, the one-year timely filing ...
The next 4 weeks we will be providing you with a step by step guide to why medical billing is now part of our Dental future.
Dental surgery is performed to treat various conditions of the teeth, jaws, and gums. Surgical procedures that dentists perform include dental implants, treatment for temporomandibular ...
tags Specl: Dental Specl: Oral and Maxillofacial Surgery
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published August 19th, 2019
Understanding how payment works with Medicare payment indicators and the impact a modifier has on payment is vital to pricing. Even if you are not billing Medicare, most carriers follow Medicare's policies for participating and non-participating rules. Here is an article from Regence on their policy statement, describing the rules ...
By Namas | Published August 16th, 2019 - Last Review/Update August 20th, 2019
Medical ID Theft
"So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ...
tags Specl: Acupuncture|Alternative Specl: Allergy|Immunology Specl: Ambulance Specl: Anesthesia|Pain Management Specl: Behavioral Health|Psychiatry|Psychology Specl: Billing Specl: Cardiology|Vascular Specl: Chiropractic Specl: Dental Specl: Dermatology|Plastic Surgery Specl: Emergency Medicine Specl: Endocrinology Specl: ENT|Otolaryngology Specl: Gastroenterology Specl: General Surgery Specl: Home Health|Hospice Specl: Internal Medicine Specl: Interventional Radiology Specl: Neurology|Neurosurgery Specl: Obstetrics|Gynecology Specl: Ophthalmology Specl: Optometry Specl: Oral and Maxillofacial Surgery Specl: Orthopedics Specl: Pediatrics Specl: Physical Medicine|Physical Therapy Specl: Pulmonology Specl: Radiology Specl: Rheumatology Specl: Skilled Nursing Specl: Urology|Nephrology
How to Properly Report Prolonged Evaluation and Management Services
By Aimee Wilcox | Published August 13th, 2019
Have you ever had a patient take more time with the provider than they were scheduled for? Do you understand which codes to report and the rules that govern them to allow for better reimbursement?
Prolonged Service codes were created just for that reason but you must carefully follow the documentation ...
tags Loc: All Locations Payer: All Payers Specl: All Specialties Specl: Behavioral Health|Psychiatry|Psychology Topic: Billing Topic: Coding Topic: CPT Coding Topic: E+M Documentation and Coding Topic: Procedure Coding
By Chris Woolstenhulme, QCC, CMCS, CPC, CMRS | Published August 13th, 2019
There are three main code sets and Healthcare Common Procedure Coding System (HCPCS), is the third most common code set used. They are often called Level II codes and are used to report non-physician products supplies and procedures not found in CPT, such as ambulance services, DME, drugs, orthotics, supplies, ...
Will Medicare Change Their Rules Regarding Coverage of Services Provided by a Chiropractor?
By Wyn Staheli, Director of Research | Published August 13th, 2019
Two separate pieces of legislation introduced in the House of Representatives (H.R. 2883 and H.R. 3654) have the potential to change some of Medicare’s policies regarding doctors of chiropractic. Find out what these two bills are all about and how they could affect Medicare policies.
Q/A: I Billed 2 Units of L3020 and Claim was Denied. Why?
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published August 13th, 2019
Question:
We billed 2 units of L3020 but were denied for not using the right modifiers. What should we do?
Answer:
Rather than submitting two units of the L3020 to indicate that the patient one orthotic for each foot, you would need to use modifiers identifying left foot and right foot. Appropriate coding ...
The OIG Work Plan: What Is It and Why Should I Care?
By Namas | Published August 9th, 2019 - Last Review/Update August 14th, 2019
The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...
tags Specl: Acupuncture|Alternative Specl: All Specialties Specl: Allergy|Immunology Specl: Ambulance Specl: Anesthesia|Pain Management Specl: Behavioral Health|Psychiatry|Psychology Specl: Billing Specl: Cardiology|Vascular Specl: Chiropractic Specl: Dental Specl: Dermatology|Plastic Surgery Specl: Emergency Medicine Specl: Endocrinology Specl: ENT|Otolaryngology Specl: Gastroenterology Specl: General Surgery Specl: Home Health|Hospice Specl: Internal Medicine Specl: Interventional Radiology Specl: Laboratory|Pathology Specl: Neurology|Neurosurgery Specl: Obstetrics|Gynecology Specl: Oncology|Hematology Specl: Ophthalmology Specl: Optometry Specl: Oral and Maxillofacial Surgery Specl: Orthopedics Specl: Pediatrics Specl: Physical Medicine|Physical Therapy Specl: Podiatry Specl: Primary Care|Family Care Specl: Pulmonology Specl: Radiology Specl: Rheumatology Specl: Skilled Nursing Specl: Urology|Nephrology Topic: Compliance Topic: Medicaid Topic: Medicare Topic: OIG
CMS Proposes to Reverse E/M Stance to Align with AMA Revisions
By Wyn Staheli, Director of Research | Published August 6th, 2019
On July 29, 2019, CMS released their proposed rule for the Medicare Physician Fee Schedule for 2020. Last year’s final rule “finalized the assignment of a single payment rate for levels 2 through 4 office/outpatient E/M visits beginning in CY 2021.” It also changed some of the documentation requirements (e.g., ...
Q/A: What if my Patient Refuses to Fill out the Outcome Assessment Questionnaire?
By ChiroCode | Published August 6th, 2019
Question:
What if my Medicare patient refuses to fill out the outcome assessment questionnaire?
Answer:
Inform the patient that Medicare requires that you demonstrate functional improvement in order for them to determine if the care is medically necessary. In other words, they may have to pay for the care out of pocket if ...
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