"News: Urgent" Articles

Click on the title to see the article summary and a link to the full article.

January 11th, 2021

HIPAA Penalty Changes

By Wyn Staheli, Director of Research | Published January 11th, 2021

On January 5, 2021, H.R. 7898 was signed into law by President Trump. This new law modifies the HITECH Act such that when an organization experiences a breach, fines and/or penalties may be reduced if (for at least a year) they have instituted “recognized security practices” as defined within the law.

November 11th, 2020

COVID Vaccine Codes Announced

By Wyn Staheli, Director of Research | Published November 11th, 2020 - Last Review/Update November 12th, 2020

On November 10, 2020, the American Medical Association (AMA) announced the addition of two new codes which will be used for the new COVID-19 vaccines along with 4 new administration codes to be used when reporting the administration of these vaccines.

October 8th, 2020

Significant COVID-19 Code Changes as of October 6

By Wyn Staheli, Director of Research | Published October 8th, 2020 - Last Review/Update October 13th, 2020

Significant COVID-19 Code Changes as of October 6

March 17th, 2020

Additional Coronavirus Testing Code Announced

By Wyn Staheli, Director of Research | Published March 17th, 2020

On March 13, 2020, a new CPT code was announced by the American Medical Association (AMA) who maintains the CPT code set. This early release of a CPT code is rare and is effective immediately.

older articles ↓

October 1st, 2019

2020 Official ICD-10-CM Coding Guideline Changes Are Here!

By Wyn Staheli, Director of Research | Published October 1st, 2019

It’s that time of year for offices to get ready for the ICD-10-CM code revisions. As part of that process, it’s also good to know what is going on with the ICD-10-CM Official Guidelines for Coding and Reporting. In the examples listed below, strikeout text is deleted and highlighted text ...

August 6th, 2019

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., ...

June 13th, 2019

Medicare Approves Reimbursement for Virtual Communication (G2012)

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published June 13th, 2019

Medicare has taken a stand to recognize communication technology-based services by approving two newly defined physicians' services that will significantly help providers who deal with phone calls and patient triage. One of these services includes: Virtual check-in (G2012), which allows the provider to be reimbursed for communicating with the patient via ...

January 28th, 2019

Empowering Medicare Beneficiaries

By Find-A-Code | Published January 28th, 2019 - Last Review/Update January 29th, 2019

BLOG: CMS announced a NEWS release today making it easier to help Medicare Beneficiaries access cost and quality information. CMS announced, "Today, the Centers for Medicare & Medicaid Services (CMS) launched a new app that gives consumers a modernized Medicare experience with direct access on a mobile device to some of ...

January 3rd, 2019

Are You Ready For the 2019 New Codes

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | 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 ...

November 7th, 2018

Are you Ready for CMS' 2019 Medicare Physician Fee Schedule Final Rule?

By Wyn Staheli, Director of Research | Published November 7th, 2018

The waiting is over, the Final Rule for CMS' 2019 Medicare Physician Fee Schedule (MPFS) is available - all 2,379 pages for those looking for a little light reading. As anticipated, there are some pretty significant changes. Most of us were carefully watching the proposed changes to the Evaluation and ...

February 5th, 2018

HIPAA Breach Settlements and Ransomware Attacks - Is Your Practice Secure?

By Wyn Staheli, Director of Research | Published February 5th, 2018

Two recent reports should make providers stop, take notice and make sure their practice's policies and procedures are up-to-date. The first one involves a HIPAA Breach settlement of a company with facilities in several states. The OCR memo stated "In addition to a $3.5 million monetary settlement, a corrective action plan ...

January 15th, 2018

Medicare Requiring Specific Modifiers on Therapy Services

By Wyn Staheli, Director of Research | Published January 15th, 2018

Medicare's MLN Matters Number: MM10176 was recently revised to identify services subject to their therapy cap. The revision became effective on January 1, 2018 and some providers have begun to receive claim rejections because they are not using the appropriate modifier. The article states the following: Services furnished under the Outpatient ...

January 10th, 2018

New MIPS Reporting Option for 2017 Data

By Wyn Staheli, Director of Research | Published January 10th, 2018

On January 2, 2018, CMS announced a new data submission system for eligible clinicians to report quality measures for the Quality Payment Program. Data may be submitted through the new platform on the qpp.cms.gov website. The announcement stated: Data can be submitted and updated any time from January 2, 2018 to March ...

January 10th, 2018

MIPS - To Participate or Not Participate - That is the Question

By Wyn Staheli, Director of Research | Published January 10th, 2018

Medicare’s Merit-based Incentive Payment System (MIPS) Final Rule increased the threshold for participation. With this increase, a significant number of providers fall into the exempt category and they are now breathing a sigh of relief. However, there’s one hidden tidbit which you may have missed - the potential damage to ...

December 4th, 2017

Revised ABN and Non-Participating Providers

By Wyn Staheli, Director of Research | Published December 4th, 2017

Non-participating providers have the option to strikeout part of the ABN form.

November 28th, 2017

Medicare Expands Value Based Plans

By Wyn Staheli, Director of Research | Published November 28th, 2017

In 2015, the CMS Innovation Center announced plans for new value-based Medicare Advantage plans in an effort to reduce healthcare costs while improving quality of care. This five year pilot program began in 2017 with seven states and is expanding to ten states for 2018. Results must have been positive because they ...

November 7th, 2017

Four Final Rules Affecting CMS Payments for 2018

By Wyn Staheli, Director of Research | Published November 7th, 2017

It’s a season for changes. CMS just finalized four rules which directly impact the following payment systems: Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY 2018 Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes for 2018 HHAs: Payment Changes for 2018 Quality Payment Program Rule for Year 2 This ...

November 6th, 2017

New Payment Rulings Could Affect You

By Wyn Staheli, Director of Research | Published November 6th, 2017

Fall has always been the season for CMS fee changes and on November 2, 2017, CMS announced the finalization of four rules which directly impact the following payment systems: Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY 2018 Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes ...

November 6th, 2017

Payment Rulings and Small Provider Practices

By Wyn Staheli, Director of Research | Published November 6th, 2017

October 6th, 2017

HIPAA Disclosures to Family, Friends, and Others Involved in an Individual’s Care and for Notification

By Wyn Staheli | Published October 6th, 2017

In light of recent tragic events, the OIG has released a reminder that HIPAA allows for certain disclosures in these types of situations. The reminder dated October 3, 2017 states the following: Following the recent mass shooting in Las Vegas, the HHS Office for Civil Rights (OCR) is taking this opportunity ...

June 16th, 2017

CMS Overpaid Providers $729 Million in Incentive Payments

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published June 16th, 2017

Medicare paid hundreds of millions in electronic health record incentive payments that did not comply with federal requirements according to the OIG. The OIG estimated CMS inappropriately paid $729,424,395 to EPs who did not meet the requirements for meaningful use. Eligible professional’s (EP’s) are physicians, dentists, podiatrists, optometrists or chiropractors, if ...

January 23rd, 2017

Virtual Groups and MIPS

By Wyn Staheli, Director of Research | Published January 23rd, 2017

During the comment period of the MIPS Proposed Rule (Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models), there were some concerns about NPI and TIN usage for MIPS reporting for smaller organizations. The following statements are from the MIPS Final ...

December 13th, 2016

Health Risk Assessment

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 13th, 2016

Risk Adjustment models are used to calculate risk scores used in predicting average beneficiaries healthcare expenditures. Currently Medicare Advantage and Prescription Drug programs include a risk adjustment as a component of the bidding and payment process to standardize bids, compare bids, and adjust plan payments. If you are not familiar ...

May 3rd, 2016

Using the SBIRT

By Wyn Staheli, Director of Research | Published May 3rd, 2016

Screening, Brief Intervention, and Referral to Treatment (SBIRT) services are an effective tool for healthcare providers to identify, reduce, and prevent problematic substance use disorders. Healthcare practices can help their patients and improve their integrated care standards with the proper use of the SBIRT.

April 30th, 2016

Phase 2 of OCR HIPAA Audits Begins

By Wyn Staheli, Director of Research | Published April 30th, 2016

Phase 2 of HIPAA audits have begun. What do you need to know?

February 1st, 2016

Medical Insurance Billing For Dental Providers

By Christine Taxin | Published February 1st, 2016 - Last Review/Update March 1st, 2016

USING FIND A CODE IN A NEW WAY

February 1st, 2016

Medicare -To Participate or Not!

By | Published February 1st, 2016 - Last Review/Update February 18th, 2016

What are the reasons for looking into Medicare as a dentist? You do have choices, pick the best option for your office.

January 29th, 2016

Announcing Find-A-Codes newest addition - Medical /Lab Test Information

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published January 29th, 2016

Announcing Find-A-Codes Newest product: Medical /Lab Test Information, available with your Find-A-Code subscription.Test information includes: overview of the test utility - when/why/how the test is used diseases the test is often used to detect or monitor specimen collection methods/procedures testing methodology usual turnaround time interpretation of test results reference ranges for test results (normal, abnormal, etc.) diagnosis and billing ...

October 8th, 2015

New EHR Final Rule

By Wyn Staheli, Director of Research | Published October 8th, 2015

There is a new Final Rule scheduled to be published in the Federal Register on October 16, 2015. There are changes to the requirements of the EHR Incentive Program which are aimed to ease the burden on providers.

July 13th, 2015

Dentists: Prescriptions and Referring to other providers with Medicare

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published July 13th, 2015

Are you aware you must be participating with Medicare Part D to be eligible to prescribe medication's to patients that have Medicare? If you are not participating, your patients will not be able to fill their prescriptions. You may also enroll to become an ordering and referring Medicare provider. You will not be recognized ...

April 15th, 2015

SGR Repeal Passes

By Wyn Staheli, Director of Research | Published April 15th, 2015 - Last Review/Update February 3rd, 2017

On April 14, 2015, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed the Senate by an overwhelming vote of 92-8. Although President Obama has not officially signed the bill into law, weeks ago he indicated his full support when H.R. 2 passed the House of Representatives. For over a decade, ...

March 27th, 2015

Will the SGR be Repealed?

By Wyn Staheli, Director of Research | Published March 27th, 2015 - Last Review/Update June 9th, 2016

It appears that the repeal of the Sustainable Growth Rate formula (SGR) could finally be a real possibility. On Thursday, March 26, The U.S. House of Representatives overwhelmingly passed H.R 2, The Medicare Access and CHIP Reauthorization Act which includes both repeal and replace the flawed SGR formula that has ...

January 9th, 2015

2015 Flexible ORYX Performance Measure Reporting Options available

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published January 9th, 2015 - Last Review/Update March 1st, 2016

The Joint Commission has released the 2015 reporting measure reporting options; you have three options to choose from in 2015. The Joint Commission will be providing accredited hospitals greater flexibility in meeting ORYX® performance measure reporting requirements beginning with measure set selections for calendar year 2015. NOTE: The Joint Commission will remove ...

January 8th, 2015

Modifier -59 Could Impact your Reimbursement - New Coding Requirements!

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published January 8th, 2015 - Last Review/Update March 1st, 2016

Centers for Medicare & Medicaid Services (CMS) is establishing four new HCPCS modifiers to define subsets of the -59 modifier, a modifier used to define a â€œDistinct Procedural Service.â€ The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such ...

November 21st, 2014

CMS Announces a Getting Started with Quality Measures Virtual Office Hours Session for 2014 Physician Quality Reporting System (PQRS)

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published November 21st, 2014 - Last Review/Update March 1st, 2016

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that a Virtual Office Hours session regarding Getting Started with Quality Measures has been scheduled for Monday, November 17, 2014 from 3:00–4:00 PM ET This session will allow stakeholders an opportunity to ask a CMS representative questions about getting ...

November 21st, 2014

Modifier 50

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published November 21st, 2014 - Last Review/Update January 30th, 2017

Modifier Review: Modifier -50 Modifier 50 is used to report a procedure performed bilaterally. Example: The patient underwent bilateral tympanostomy with insertion of ventilating tubes. If you look up the CPT code 69433, you will see it is a unilateral procedure and there are instructions telling you to append modifier -50 if ...

November 21st, 2014

Get Ready! Improve your Clinical Documentation!

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published November 21st, 2014 - Last Review/Update March 1st, 2016

It is time to start improving your clinical documentation to prepare your practice for ICD-10. Select the codes most often used in your practice. Now, you need to determine if your current documentation is sufficient to support ICD-10. It would be best to assume it is not, since ICD-9 was not ...

November 10th, 2014

Reduce The Need To Turn Patients Over To A Collection Agency

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published November 10th, 2014 - Last Review/Update January 30th, 2017

If you have worked in billing and reimbursement, you are aware that turning patients over to a collection agency to collect on a debt should always be a last resort. Are your office policies conducive to retaining happy, paying patients or harming the word-of-mouth advertizing so important to medical providers ...

October 20th, 2014

CMS Announces 2013 eRx Incentive Program Payments are Now Available

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 20th, 2014 - Last Review/Update March 2nd, 2016

CMS is pleased to announce that the 2013 Electronic Prescribing (eRx) Incentive Program incentive payments are now available for eligible professionals and group practices who submitted data for Medicare Physician Fee Schedule Part B services provided January 1, 2013 through December 31, 2013. As required by law, President Obama issued a ...

October 20th, 2014

4Medapproved Partner and Find-A-Code's first Mini-Course Workshop

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 20th, 2014 - Last Review/Update March 2nd, 2016

Find-A-Code is now a 4Medapproved Partner and we are announcing our first Mini-Course workshop. PROGRAM ANNOUNCEMENT 10/17/2014 Our first mini-course workshop will be presented by Brian Johnson, CHSP, CHSA: HIPAA Workforce Certificate for Professionals LIVE Accelerated Workshop (1 Day/1 Hour) LIVE ONLINE: Oct 29, 2014 at Noon EST, 11am CST, 10am MST and ...

October 16th, 2014

Basic Fact Sheet on HIPPA Privacy and Security for Providers - CMS

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 16th, 2014 - Last Review/Update January 30th, 2017

CMS has a released a fact sheet on HIPAA Privacy and Security basics for providers. Designed to provide education on covered entities and Business Associates under the HIPPA Privacy Rule. Examples of a Covered Entity would be: Doctors Clinics Psychologists Dentists Chiropractors Nursing Homes Pharmacies Health Plans Clearing houses Any person or organization assisting in transmitting a transaction in electronic form, ...

October 9th, 2014

Modifier 24

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published October 9th, 2014 - Last Review/Update January 30th, 2017

Modifier -24 When a patient is seen during a global (postoperative) period for something unrelated to the surgery for which the global period applies, modifier -24 is appended to the evaluation and management (EM) service. The insurance may deny payment for the EM service; however, if the notes for that service ...

October 3rd, 2014

ICD-10 and Clinical Documentation CME/CE

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 3rd, 2014 - Last Review/Update January 30th, 2017

MedScape is offering a free training activity for healthcare providers who will be involved in clinical documentation with ICD-10. This activity is to make providers aware of the key elements of good clinical documentation. CME/CE Released: 09/15/2014; Valid for credit through 09/15/2015 Link ...

September 26th, 2014

Patient Electronic Access Tipsheet - Measure Compliance

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published September 26th, 2014 - Last Review/Update January 30th, 2017

MEASURE COMPLIANCE - Meeting the Patient Electronic Access Objective Starting in 2014, CMS requires that providers participating in both Stage 1 and Stage 2 of the EHR Incentive Programs must meet the Patient Electronic Access objective, which gives patients access to their health information in a timely manner. Providers participating in ...

September 18th, 2014

PQRS Web Based Training

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published September 18th, 2014 - Last Review/Update January 30th, 2017

The CMS Physician Quality Reporting System (PQRS) Program: "What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training Course — Released “The CMS Physician Quality Reporting System (PQRS) Program: What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training (WBT) Course was released and is now available. This WBT ...

September 9th, 2014

How To Collect, Maintain and Use Insurance Fee Schedules

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published September 9th, 2014 - Last Review/Update January 30th, 2017

Fee SchedulesDo you know what the fee schedules are for each of your top insurance companies? Do your providers know how much they are getting paid for the services they provide and manage their practice to maximize reimbursement? Learn how to maximize reimbursement by knowing, understanding and using insurance fee schedules ...

article requests

If you would like a specific article written on a medical coding and billing topic, please contact us.

contact

innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Email:

article topics

Thank you for choosing Find-A-Code, please Sign In to remove ads.

MY NEWSLETTERS

FEES

FACILITY

RISK ADJUSTMENT

"News: Urgent" Articles

HIPAA Penalty Changes

COVID Vaccine Codes Announced

Significant COVID-19 Code Changes as of October 6

Additional Coronavirus Testing Code Announced

2020 Official ICD-10-CM Coding Guideline Changes Are Here!

CMS Proposes to Reverse E/M Stance to Align with AMA Revisions

Medicare Approves Reimbursement for Virtual Communication (G2012)

Empowering Medicare Beneficiaries

Are You Ready For the 2019 New Codes

Are you Ready for CMS' 2019 Medicare Physician Fee Schedule Final Rule?

HIPAA Breach Settlements and Ransomware Attacks - Is Your Practice Secure?

Medicare Requiring Specific Modifiers on Therapy Services

New MIPS Reporting Option for 2017 Data

MIPS - To Participate or Not Participate - That is the Question

Revised ABN and Non-Participating Providers

Medicare Expands Value Based Plans

Four Final Rules Affecting CMS Payments for 2018

New Payment Rulings Could Affect You

Payment Rulings and Small Provider Practices

HIPAA Disclosures to Family, Friends, and Others Involved in an Individual’s Care and for Notification

CMS Overpaid Providers $729 Million in Incentive Payments

Virtual Groups and MIPS

Health Risk Assessment

Using the SBIRT

Phase 2 of OCR HIPAA Audits Begins

Medical Insurance Billing For Dental Providers

Medicare -To Participate or Not!

Announcing Find-A-Codes newest addition - Medical /Lab Test Information

New EHR Final Rule

Dentists: Prescriptions and Referring to other providers with Medicare

SGR Repeal Passes

Will the SGR be Repealed?

2015 Flexible ORYX Performance Measure Reporting Options available

Modifier -59 Could Impact your Reimbursement - New Coding Requirements!

CMS Announces a Getting Started with Quality Measures Virtual Office Hours Session for 2014 Physician Quality Reporting System (PQRS)

Modifier 50

Get Ready! Improve your Clinical Documentation!

Reduce The Need To Turn Patients Over To A Collection Agency

CMS Announces 2013 eRx Incentive Program Payments are Now Available

4Medapproved Partner and Find-A-Code's first Mini-Course Workshop

Basic Fact Sheet on HIPPA Privacy and Security for Providers - CMS

Modifier 24

ICD-10 and Clinical Documentation CME/CE

Patient Electronic Access Tipsheet - Measure Compliance

PQRS Web Based Training

How To Collect, Maintain and Use Insurance Fee Schedules

article requests

contact

article topics