"Acupuncture|Alternative" & "ABC Coding" Articles

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February 3rd, 2021

How To Properly Report Prolonged Services Using 99417 or G2212

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published February 3rd, 2021

Prolonged Evaluation & Management codes underwent big changes in 2021, including the creation of a new prolonged code (99417), reportable only with codes 99205 or 99215. While Medicare has agreed to accept the AMA's CPT E/M coding changes, they have formulated an opinion contrary to how CPT calculates time specific ...

April 16th, 2020

Hypertension ICD-10-CM Coding Table, Guidelines, and Tips

By Wyn Staheli, Director of Research & Aimee Wilcox, Director of Content | Published April 16th, 2020

Coding hypertension properly requires knowing all the guidelines. This article summarizes how hypertension is coded using ICD-10-CM and includes tips, definitions and a very helpful coding table summarizing your options.

March 26th, 2020

New Biofeedback Codes to replace 90911 Eff 2020-01-01

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published March 26th, 2020

CMS announced 90912 and 90913 are to be used starting January 2020 in place of 90911. According to CMS MLN, these new codes, designated as “sometimes therapy”, are reported to furnish these services outside a therapy plan of care when appropriate. Codes are permitted to be used by physicians and Non-Physician Practitioners (NPPs), ...

February 19th, 2020

Medicare Begins Covering Acupuncture Services

By Wyn Staheli, Director of Research | Published February 19th, 2020

Medicare is changing their policy regarding coverage of acupuncture, but in order to provide these services, you must follow their rules.

January 30th, 2020

Medicare Announces Coverage of Acupuncture Services

By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published January 30th, 2020

On January 21, 2020, a CMS Newsroom press-release read, This new announcement is both exciting and refreshing. Acupuncture, a key component of traditional Chinese medicine and most commonly used to treat pain, is now being officially recognized by Medicare and several other large payers as a covered, alternative treatment option for ...

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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 ...

September 30th, 2019

New Codes for Dry Needling

By Wyn Staheli, Director of Research | Published September 30th, 2019

Find out what you need to know about the new codes for dry needling, also known as trigger point acupuncture.

August 16th, 2019

Medical ID Theft

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. ...

August 9th, 2019

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 ...

July 17th, 2019

Act Now on CMS Proposal to Cover Acupuncture for Chronic Low Back Pain

By Wyn Staheli, Director of Research | 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.

July 12th, 2019

5 Ways to Minimize HIPAA Liabilities

By BC Advantage | Published July 12th, 2019 - Last Review/Update July 30th, 2019

Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...

October 17th, 2018

Wolters Kluwer Drug Pricing

By Find-A-Code | Published October 17th, 2018

Wolters Kluwer provides unit and package pricing for multiple drug price types: Average Wholesale Price (AWP), Wholesale Acquisition Cost (WAC), Direct Price (DP), Manufacturer's Suggested Wholesale Price (SWP), Centers for Medicare & Medicaid Services, Federal Upper Limit (CMS FUL), Average Average Wholesale Price (AAWP), Generic Equivalent Average Price (GEAP). Average...

November 21st, 2014

Coding for Laser Therapy

By | Published November 21st, 2014 - Last Review/Update January 30th, 2017

The Rule of Coding: Service Codes define "what" you do; diagnosis codes define "why" you're doing it. Billing for laser or any other service must be properly defined and supported by both a service code and a diagnoses code. Coverage for laser, as with any other service, is strictly dependent upon the ...

November 21st, 2014

Understanding TOS Discounts and DMPOs

By | Published November 21st, 2014 - Last Review/Update January 30th, 2017

Time-of-Service (TOS) discounts are a common occurrence in chiropractic. What is often assumed is that if insurance isn't involved, there are no rules that apply. Unfortunately, this is a myth that can become costly to practices and damage provider/patient relationships. So read on to learn the facts about TOS discounting and ...

October 17th, 2014

Acupuncture ICD-10 Common Codes

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 17th, 2014 - Last Review/Update January 30th, 2017

The following is a short list of some other handy ICD-10 codes: M76.50 Patellar tendinitis, unspecified kneeM76.51 Patellar tendinitis, right kneeM76.52 Patellar tendinitis, left kneeM05.33 Rheumatoid arthritisM15.9Polyosteoarthritis, unspecified (generalized osteoarthritis NOS)M16.10 Unilateral primary osteoarthritis, unspecified hipM54.40 Lumbago with sciatica, unspecified sideM54.41 Lumbago with sciatica, right sideM54.42 Lumbago with sciatica, left sideM54.6 Pain in the thoracic spineM54.9Dorsalgia, unspecified (backache NOS, back ...

October 16th, 2014

Acupuncture ICD-10-CM Billing

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

If all the criteria are met, pain codes for the most part will be reimbursed by insurance. Keep in mind there are only a limited number of diagnosis codes that are considered medically necessary for treatment to be covered. Low back pain is perhaps one of the most universally accepted diagnoses. General ...

October 9th, 2014

Acupuncture and the Treatment of Headaches

By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 9th, 2014 - Last Review/Update January 30th, 2017

Acupuncture services are often reimbursed for the treatment of headaches. For examples on headache codes and coding for headaches with ICD-10, visit HealthCMi ...

September 15th, 2014

Medicare Definition of Timed Codes

By Wyn Staheli, Director of Research | Published September 15th, 2014 - Last Review/Update July 12th, 2016

Many procedure codes are considered "timed codes," that is, the number of units are determined by the amount of time spent performing the service. Medicare Claims Processing Manual, Chapter 5 clarification included here.

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