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Recent articles:Click on the title to see the article summary and a link to the full article. January 14th, 2019 AMA Issues new CMT Information| Published January 14th, 2019
As many of you may already be keenly aware, there have been ongoing problems with many payers (e.g., BCBS of Ohio) regarding the appropriateness of reporting an E/M visit on the same day as CMT (CLICK HERE to read article). The AMA recently released an FAQ which renders their opinion ... Tags: Specl: Chiropractic Topic: CPT Coding Topic: E+M Documentation and Coding Topic: Modifier Coding Topic: Procedure Coding January 14th, 2019 Scanning the Unscannable: Improving Patient Flow in MRI| Published January 14th, 2019
Stay Ahead of your CEUs in 2019Get the latest webinars and earn over 24 CEUs each year included with your BC Advantage Magazine subscription.
Latest Webinar: Scanning the Unscannable: Improving Patient Flow in MRI
Presenter: Wendy Stirnkorb, President & CEO Stirnkorb Consulting, LLC
Time: 46 Minutes Cost: $0.00 to all BC Advantage Magazine Subscribers CEUs: 1.0 On-demand: Watch 24/7 from work or ... Tags: Specl: Radiology Topic: CEUs January 14th, 2019 What is Virtual Communication (G0071)?| Published January 14th, 2019 - Last Review/Update January 16th, 2019
Beginning January 1st, 2019 all of our RHC and FQHC organizations have a new CPT code to
consider implementing for their Medicare populous (check per Advantage Plan Administration for coverage). In its current form, this code is not reportable by organizations not meeting the RHC/FQHC designation.
The code isG0071 and is termed ... Tags: Specl: Billing Topic: CPT Coding Topic: HCPCS Coding January 10th, 2019 How to Report Co-Surgeons Using Modifier 62| Published January 10th, 2019
Modifier 62 is appended to surgical claims to report the need for the skills of two surgeons (co-surgeons) to perform a procedure, with each surgeon performing a distinct part of the same procedure, during the same surgical session.
An easy way to explain this is to visualize a patient requiring cervical fusion where ... Tags: Loc: All Locations Payer: All Payers Specl: All Specialties Topic: Auditing Topic: Coding Topic: Documentation Topic: ICD9v3 Coding Topic: Medicare Topic: Modifier Coding Topic: Procedure Coding January 10th, 2019 Are You Protecting Your Dental Practice From Fraud?| Published January 10th, 2019
With the expansion of dental coverage through Medicaid and Medicare Advantage plans, an ever-increasing number of dental claims have come under scrutiny for fraud. One such payer, Aetna, is actively pursuing dental fraud by employing their special investigative units (SIUs) to identify and investigate providers who demonstrate unusual coding and ... Tags: Payer: All Payers Specl: All Specialties Topic: Auditing Topic: CDT (Dental) Codes Topic: Claims Processing Topic: Denial Management Topic: Fraud Topic: Insurance Topic: Payer Guidelines Topic: Practice Management Topic: Procedure Coding Topic: Training January 4th, 2019 Nine New Codes for Fine Needle Aspirations (FNA)| Published January 4th, 2019
If your practice performs a lot of fine needle aspirations (FNA), you probably have the code options memorized (10021 without image guidance and 10022 with image guidance). However, the 2019 CPT codes now include nine (9) new FNA codes (10004-10012), one deleted FNA code (10022) and one revised FNA code ... Tags: Loc: All Locations Payer: All Payers Specl: Allergy|Immunology Specl: Cardiology|Vascular Specl: Dermatology|Plastic Surgery Specl: Emergency Medicine Specl: Endocrinology Specl: ENT|Otolaryngology Specl: Gastroenterology Specl: General Surgery Specl: Internal Medicine Specl: Interventional Radiology Specl: Neurology|Neurosurgery Specl: Obstetrics|Gynecology Specl: Oncology|Hematology Specl: Ophthalmology Specl: Oral and Maxillofacial Surgery Specl: Orthopedics Specl: Pediatrics Specl: Podiatry Specl: Primary Care|Family Care Specl: Pulmonology Specl: Radiology Specl: Rheumatology Specl: Urology|Nephrology Topic: Auditing Topic: Billing Topic: CPT Coding Topic: Modifier Coding January 3rd, 2019 Dry Needling| Published January 3rd, 2019 The correct coding of dry needling, also known as trigger point needling, has been a subject of confusion for quite some time. The American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA) have been working together for several years to obtain appropriate codes to describe this service. In ... Tags: Specl: All Specialties Specl: Chiropractic Topic: Codapedia Topic: CPT Coding Topic: Modifier Coding Topic: Procedure Coding January 3rd, 2019 CMS Finalizes Major Changes to ACO Program| Published January 3rd, 2019 Back in August of 2018, as part of the Medicare Shared Savings Program (Shared Savings Program), CMS proposed some sweeping changes for Accountable Care Organizations (ACOs). There has been some controversy over these changes which require ACOs to move to two-sided models. In this Final Rule which was scheduled to be published in the Federal Register ... Tags: Payer: CMS|Medicare Specl: All Specialties Topic: Health Care Reform Topic: Medicare January 3rd, 2019 Are You Ready For the 2019 New Codes| Published January 3rd, 2019 Many articles have been published regarding the 2019 proposed Evaluation and Management coding changes, but hopefully you have taken the time to review those in detail and be ready for them. If not, here is a link to a Find-A-Code article written by Wyn Staheli (Director of Research) entitled, “Are You Ready ... Tags: Topic: Codapedia Topic: Coding Topic: CPT Coding January 3rd, 2019 2019 Coding Changes for Chiropractic| Published January 3rd, 2019
The new year is upon us and so it’s time to double check and make sure we are ready. Those with Premium Membership can use the ChiroCode Online Library and search all the official code sets: ICD-10-CM, CPT, and HCPCS. It also includes the updated NCCI edits and RVUs for ... Tags: Specl: Chiropractic Topic: CPT Coding Topic: HCPCS Coding Topic: ICD10CM Coding January 3rd, 2019 New Genetic Test for Severe Inherited Conditions| Published January 3rd, 2019
For 2019 a new code has been introduced (81443) which represents genetic testing for 15 genes associated with severe, inherited conditions. The results of this test may be used to identify carrier status during prenatal genetic counseling, confirm a clinical diagnosis, or identify at-risk family members for the following severe ... Tags: Loc: All Locations Specl: Laboratory|Pathology Topic: CPT Coding January 3rd, 2019 Welcome 2019 CPT Codes!| Published January 3rd, 2019
The AMA has released the New, Revised and Deleted CPT codes these are currently available on Find-A-Code. View the entire list of changes on the CODE tab and select CPT. Be sure to review all of the changes effective January 01, 2019.
168 New Codes
72 Deleted Code
51 Revised Codes
Here are ... Tags: Topic: CPT Coding December 20th, 2018 The Diabetic Patient and Medical Manifestations| Published December 20th, 2018 Tags: Topic: CDT (Dental) Codes Topic: CPT Coding Topic: ICD10CM Coding December 20th, 2018 Flexion-Distraction Billing Clarification| Published December 20th, 2018 Recently we posted a Q/A with stated that Cox-flexion distraction was not billable with code 97012. We received a comment from a customer stating that was not entirely correct because there is an add-on to the standard Cox table which satisfied the mechanical requirements to use code 97012. This article ... Tags: Specl: Chiropractic Topic: CPT Coding Topic: Procedure Coding December 18th, 2018 Quality Measures Finalized for 2019| Published December 18th, 2018 CMS recently announced that the quality measures for 2019 have been finalized. There are new eligible clinicians so be aware of how that may affect your organization. New ECs are:
Physical therapists
Occupational therapists
Qualified speech-language pathologists
Qualified audiologists
Clinical psychologists
Registered dietitian or nutrition professionals
The following are changes to Electronic Clinical Quality Measures (eCQMs) available ... Tags: Topic: Quality Payment Program December 18th, 2018 Medicare Advantage Providers are not Required to be Enrolled in Medicare| Published December 18th, 2018
There was a ruling that was requiring providers to be enrolled in Medicare in order to provide services for Part C (Medicare Advantage (MA)) and/or Part D. However, on April 2, 2018, CMS released the 2019 Final Rules for MA and Part D which changed this previous ruling. According to ... Tags: Payer: CMS|Medicare Topic: Compliance Topic: Medicare December 18th, 2018 Are HIPAA Changes Coming?| Published December 18th, 2018
On December 14, 2018, the Office for Civil Rights (OCR) issued a Request for Information (RFI). They are considering making changes to some of the HIPAA regulations. Earlier this year at the HIMSS (Healthcare Information and Management Systems Society) meeting, Roger Severino, the head of the Office for Civil Rights ... Tags: Topic: Compliance Topic: HIPAA December 18th, 2018 Reporting Unilateral or Bilateral Codes| Published December 18th, 2018 - Last Review/Update December 20th, 2018 Generally, Audiology tests are coded as if they were performed on both ears, if the testing was performed only on one ear, you are required to append a modifier to acknowledge there was a reduced service or a unilateral assessment, using modifier 52 - Reduced Services. (Be sure to read... Tags: Specl: ENT|Otolaryngology Topic: Modifier Coding December 7th, 2018 Keeping Up to Date| Published December 7th, 2018 - Last Review/Update December 20th, 2018 Keeping up to date on coding and documentation changes, is critical for medical coders, billers, auditors, and compliance personnel. Every year American Medical Association (AMA) creates, revises, and deletes CPT codes on January 1st. Same thing occurs with the ICD-10 codes in October. For CPT codes, the intention of the... Tags: Topic: Coding Topic: Compliance Topic: Documentation November 30th, 2018 Auditing looking between the lines| Published November 30th, 2018 - Last Review/Update January 9th, 2019 When given the task of auditing a group of charts, most often the scope of the audit is well defined. For me, there are times when my natural inquisitive nature turns on and I find my noticing the "timing" of parts of documentation. These are things that you would not... Tags: Topic: Auditing Topic: Documentation Topic: Practice Management |
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