How does the VA determine charges billed to third party payers for Veterans with private health insurance?
According to the VA. "38 C.F.R 17.101 stipulates the basic methodology by which VA bills third party insurance carriers. In order to generate a charge for medical services, VA establishes reas... Read More
Have you noticed your LCDs are missing something? CMS is moving codes out of LCDs and into Billing and Coding Articles. MACs began moving ICD-10-CM, CPT/HCPCS, Bill Type, and Revenue codes in January 2019, and will continue through January 2020. Therefore, if there is an LCD with its... Read More
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... Read More
Find-A-Code Announces: UCR Fees are Available on DRGs!
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... Read More
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 a lot of attention; 6 new codes play a vital part in patients taking part in their care from their own home. New patient-initiated online di... Read More
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 ... Read More
Level II Coding Procedures called HCPCS or Level II codes.
There are three main code sets and the 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 pro... Read More
CMS Proposes to Reverse E/M Stance to Align with AMA Revisions
By: Wyn Staheli, Director of ResearchPublished: 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 assig... Read More
No single article could possibly cover all the possible problems that could be encountered in your practice. However, it’s always a good idea to pay attention to problems that others are encountering to try and keep them from happening to you. The skills that make an individual a good prov... Read More