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Recent articles:Click on the title to see the article summary and a link to the full article. July 17th, 2019 Act Now on CMS Proposal to Cover Acupuncture for Chronic Low Back Pain| Published July 17th, 2019 Now is the time to comment on a proposal to cover acupuncture for chronic low back pain. This comment period is the part of the HHS response to the opioid crisis. You only have until August 14th to officially comment. Tags: Specl: Acupuncture|Alternative Specl: Chiropractic Specl: Physical Medicine|Physical Therapy Topic: Billing Topic: Medicare July 16th, 2019 Are you Treating & Billing Medical Patients Tooth Infections| Published July 16th, 2019
A tooth infection, or an abscessed tooth, generally occurs as a result of tooth decay and poor oral hygiene. However, it can also develop due to previous dental work or traumatic injury. When an infection occurs, it causes a pocket of pus to form in the mouth as a result ... Tags: Specl: Dental Specl: Oral and Maxillofacial Surgery July 15th, 2019 Denial Management is Key to Profitability| Published July 15th, 2019 Tags: Topic: Compliance Topic: CPT Coding Topic: Denial Management Topic: HCPCS Coding July 15th, 2019 Q/A: Do I Use 7th Character A for all Sprain/Strain Care Until MMI?| Published July 15th, 2019 Question:
It is in regards to the Initial and Subsequent 7th digit (A and D) for sprains and strains. Recently, I have been told that I should continue with the A digit until the patient has reached Maximum Medical Improvement (MMI) and then switch over to the D place holder. Is ... Tags: Specl: Chiropractic Specl: Physical Medicine|Physical Therapy Topic: Coding Topic: ICD10CM Coding Topic: Modifier Coding July 9th, 2019 The Importance of Medical Necessity| Published July 9th, 2019
ICD-10-CM codes represent the first line of defense when it comes to medical necessity. Correctly chosen diagnosis codes support the reason for the visit as well as the level of the E/M services provided. The issue of medical necessity is one of definitions and communication. What is obvious to the ... Tags: Topic: Billing Topic: Coding Topic: CPT Coding Topic: Diagnosis Coding Topic: Documentation July 9th, 2019 When Can You Bill Orthosis Components Separately?| Published July 9th, 2019 Othoses often have extra components. When can you bill those components separately? For example, can you bill for a suspension sleeve (L2397) with a knee orthosis (e.g., L1810)? Tags: Topic: DME Topic: HCPCS Coding Topic: Supply Coding July 8th, 2019 Q/A: Can I Put the DC’s NPI in Item Number 24J for Massage Services?| Published July 8th, 2019 Question:
Are there scenarios in which it is acceptable to put the DC's NPI in box 24j for massage services?
Answer:
While the answer to this is yes, it is essential to understand that there are very limited scenarios. In most cases, Item Number 24J is only for the NPI of the individual ... Tags: Specl: Chiropractic Topic: Billing Topic: Compliance July 8th, 2019 Will the New Low Level Laser Therapy Code Solve Your Billing Issues?| Published July 8th, 2019
Low level laser therapy (LLLT), also known as cold laser therapy, is a form of phototherapy which uses a device that produces laser beam wavelengths, typically between 600 and 1000 nm and watts from 5–500 milliwatts (mW). It is often used to treat the following:
Inflammatory conditions (e.g., Rheumatoid Arthritis, Carpal ... Tags: Specl: Chiropractic Specl: Physical Medicine|Physical Therapy Topic: CPT Coding Topic: HCPCS Coding Topic: ICD9 Coding Topic: Procedure Coding July 5th, 2019 Helping Others Understand How to Apply Incident to Guidelines| Published July 5th, 2019 - Last Review/Update July 16th, 2019 Over the past few months, I have worked with different organizations that have been misinterpreting the "incident to" guidelines and, in return, have been billing for services rendered by staff that are not qualified to perform the services per AMA and CPT. What I found within the variances is that ... Tags: Payer: CMS|Medicare Specl: All Specialties Topic: Auditing Topic: Medicare July 1st, 2019 Rules for Rendering Unproven, Investigational or Experimental Procedures| Published July 1st, 2019
If you haven’t reviewed your state guidelines or taken a recent look at third-party payer policies on unproven, investigational or experimental procedures, now is the perfect time to make sure you’re up to speed with this important information. Most providers are surprised to see commonly used devices or techniques listed ... Tags: Specl: Chiropractic Topic: Compliance July 1st, 2019 Q/A: Do I Really Need to Have an Interpreter?| Published July 1st, 2019 Question:
I heard that I need to have an interpreter if someone who only speaks Spanish comes into my office. Is this really true?
Answer:
Yes! There are both state and federal laws that need to be considered. The applicable federal laws are:
Title VI of the Civil Rights Act of 1964,
Americans with Disabilities ... Tags: Topic: Compliance Topic: HCPCS Coding Topic: Procedure Coding June 27th, 2019 2018 Medicare Improper Payment Report Shows Slight Improvement but There's Still Work to be Done| Published June 27th, 2019 - Last Review/Update July 8th, 2019 The Medicare Improper Payment Report for 2018 is not a measurement of fraud. Rather, it is an estimate of the claims paid by Medicare which did not meet Medicare coverage, coding, and billing rules. The estimated Medicare FFS payment accuracy rate (claims paid correctly) from July 1, 2016 through June 30, 2017, was 91.9 percent. ... Tags: Specl: All Specialties Topic: Compliance Topic: Documentation June 25th, 2019 Q/A: Can I Refuse to File a Patient's Medical Insurance for an Auto Accident?| Published June 25th, 2019 Question:
Can a Chiropractor refuse to file a patients Medical Insurance for an Auto Accident?
Answer:
There isn't a simple answer to this question. It depends on who is responsible and state laws. Who is responsible (the auto insurance or the medical insurance) can depend on state requirements as well as who is ... Tags: Specl: Chiropractic Topic: Compliance Topic: PI - Personal Injury June 24th, 2019 The Oral Connection| Published June 24th, 2019 - Last Review/Update June 27th, 2019 The mouth is, was, and forever will be part of the body. The old model in traditional medicine of treating symptoms and body parts in isolation is flawed. Pioneers in functional medicine like Dr. Mark Hyman, Dr. Mike Roisen, Dr. Axe, Dr. Fuhrman, Dr. Amy Doneen, Dr. Brad Bale, and ... Tags: Specl: Dental Specl: Oral and Maxillofacial Surgery June 21st, 2019 Small Breaches Can Be Subject to Large Penalties| Published June 21st, 2019 - Last Review/Update June 27th, 2019 Small Breaches Can Be Subject to Large Penalties
We may have heard about the large fines issued by the Office for Civil Rights (OCR) against big organizations like Anthem or the University of Texas MD Anderson Cancer Center. These organizations have been in the news due to privacy breaches that constituted violations ... Tags: Specl: All Specialties Topic: Compliance Topic: HIPAA Topic: Practice Management June 20th, 2019 Don't Let Your QPro Certification(s) Expire! Your Certifications Matter!| Published June 20th, 2019 Hello QPro Members, Just a friendly reminder! ... Tags: June 18th, 2019 How to Properly Report Monitoring Patients Taking Blood-thinning Medications| Published June 18th, 2019 - Last Review/Update June 19th, 2019 Codes 93792 and 93792, which were added effective January 1, 2019, have specific guidelines that need to be followed. This article provides some guidance and tips on properly reporting these services. Tags: Specl: Cardiology|Vascular Specl: Home Health|Hospice Specl: Internal Medicine Specl: Neurology|Neurosurgery Specl: Obstetrics|Gynecology Specl: Orthopedics Specl: Pediatrics Specl: Primary Care|Family Care Specl: Skilled Nursing Topic: Billing Topic: CPT Coding Topic: HCPCS Coding Topic: ICD10CM Coding Topic: Modifier Coding June 17th, 2019 Extrapolation Policies Apply to RAD-V Audits| Published June 17th, 2019
Risk Adjustment is a program that was implemented to identify and support Medicare beneficiaries with health conditions, illnesses, or injuries that put them at risk of death or organ system/bodily function failure. Through Risk Adjustment (RA), Medicare ensures their beneficiaries are being followed at least annually for any healthcare conditions ... Tags: Loc: All Locations Payer: All Payers Specl: All Specialties Topic: Coding Topic: Guidelines ICD-10-CM Topic: Risk Adjustment June 14th, 2019 A United Approach| Published June 14th, 2019 - Last Review/Update June 18th, 2019 A United Approach
As auditors, we all have a different perspective when evaluating documentation. It would be unreasonable to think that we all view things the same way. In my opinion, differing perspectives are what makes a great team because you can coalesce on a particular chart, work it through and ... Tags: Payer: CMS|Medicare Specl: All Specialties Topic: Auditing Topic: Billing Topic: Claims Processing Topic: E+M Documentation and Coding Topic: EHR Topic: Medicare Topic: Procedure Coding June 13th, 2019 What Medical Necessity Tools Does Find-A-Code Offer?| Published June 13th, 2019 Find-A-Code is a great resource for individuals working in all aspects of healthcare, from providers and ancillary staff to the attorneys and payers who assess and critique the documentation supporting the services performed. When recently asked what tools Find-A-Code has to help support medical necessity, our response was, "We provide many resources ... Tags: Loc: All Locations Payer: All Payers Specl: All Specialties Topic: Assessment Tools Topic: Auditing Topic: Billing Topic: Claims Processing Topic: Coding Topic: Compliance Topic: CPT Coding Topic: Denial Management Topic: Documentation Topic: E+M Documentation and Coding Topic: LCDs and NCDs Topic: Payer Guidelines |
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