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Find-A-Code Focus Newsletter

2014 September Articles


Incentive Payments are Now Available for 2013 PQRS

September 29, 2014
CMS is pleased to announce that the 2013 Physician Quality Reporting System (PQRS) incentive payments are now available for eligible professionals and group practices who submitted data for Medicare Physician Fee Schedule Part B services between January 1, 2013 and December 31, 2013. The PQRS incent... Read More

Visit Find-A-Code at AHIMA in San Diego - Booth 1645

September 26, 2014
Stop by and say "Hi" - Visit Find-A-Code at booth 1645!The 86th AHIMA Convention and Exhibit takes place at a critical point in health information history, making the convention a must-attend event for professionals across all healthcare segments: providers, payers, vendors, consultants, and se... Read More

PQRS: New Quality Reporting Training Modules to Help Ensure Satisfactory 2014 Reporting

September 26, 2014
CMS has added more PQRS training modules to help simplify the process, including one for the beginner, intermediate and advanced PQRS reporting.  Designed to help you find the information you need to satisfactorily participate in PQRS and other programs that offer incentive payments in 2014.... Read More

Volunteers Sought for ICD-10 End-to-End Testing in January: Forms due October 3

September 24, 2014
January 26-30, 2015 During the week of January 26 through 30, 2015, a sample group of providers will have the opportunity to participate in ICD-10 end-to-end testing with Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor. The goal of end-to... Read More

EHR - October 3rd is the Last Day for 1st-year Medicare EPs to Begin a 2014 reporting Period

September 24, 2014
October 3rd is Last Day for 1st-year Medicare EPs to Begin a 2014 Reporting Period CMS wants to make sure you don’t miss an opportunity to receive incentive payments for the Medicare EHR Incentive Program. The last day to begin a 2014 reporting period for first-year Medicare eligible... Read More

Medicare Electronic Sumbission (EDI) links

September 24, 2014
Helpful links for Electronic submissions (EDI) See links here: NGS EDI Lnks Read More

PQRS: Questions and Answers for Psychologists

September 24, 2014
Questions and Answers for Psychologists and PQRS. In 2007 Psychologists had very limited opportunity to participate. As of 2014, there are 11 measures available for claims-based reporting and two for registry reporting.   For the entire article read more here Practice Central.or... Read More

Reduce the need to turn patients over to a collection agency.

September 24, 2014
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 medica... Read More

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

September 24, 2014
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... Read More

PQRS Web Based Training

September 23, 2014
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&r... Read More

CMS - How to Understand Medicare's ID Numbers (HIC or HICN)

September 23, 2014
A HIC number (HICN) is a Medicare beneficiary’s identification number. Also, remember when billing, ALWAYS use the name as it appears on the patient's Medicare card. Both CMS and the Railroad Retirement Board (RRB) issue Medicare HIC numbers. The format of a HIC number issued by CMS is a Soci... Read More

Other Medical Code Sets Find-A-Code Content

September 22, 2014
How many code sets are there? Find-A-Code Content Did you know? Along with the ever so popular code sets we are so familiar with and use every day such as: ICD-9, ICD-10, DRG’s, CPT, HCPCS, ICD-9 Vol. 3, CDT, ICD-10 PCS, APC and NDC codes, Find-A-Code has lists of many other code sets (To... Read More

MD Interactive offers PQRS Support

September 16, 2014
 MD interactive provides support to access disease management and registry database systems reporting PQRS to avoid penalties including:  Avoid 2% PQRS Penalty Medicare Qualified Registry Easy PQRS Submission Unlimited phone and email support Real-time performance reports Video tut... Read More

PQRS: Code intent first, then compliance for intraoperative measures group

September 16, 2014
When reporting Perioperative care measures group, make sure to submit code G8492 first to signal that the provider intends to report the perioperative care measures group before coding G8501 to show that the clinician has met the requirements for the measures group.... Read More

CMS - Reminder to Stop Duplicate Billings

September 16, 2014
Some providers routinely submit duplicate claims to Local Part B Carriers and DMERCs for a single service encounter. This is inappropriate. CMS asks providers and suppliers to discontinue this practice. Unlike other health insurance payers where it is customary to bill until paid, multiple or repet... Read More

Cyber Insurance? What kind of Insurance Policy is that?

September 11, 2014
Due to the increase of medical transactions stored online and in the cloud, cyber intrusions will only increase. Cyber insurance, also known as privacy and network security insurance, can help cover the costs incurred if your computer system is compromised, or after a data breach which can inc... Read More

Do I Need Error and Omissions (E&O) Insurance for My Billing Company?

September 11, 2014
Do I Need Error and Omissions (E&O) Insurance for My Billing Company? Over the years Medical billing has been considered low risk, now it has developed into a huge liability with HIPAA, E&O and Business Associate Agreements to name a few. HIPAA has rocked the world for small businesses. Lo... Read More

How To Collect, Maintain and Use Insurance Fee Schedules

September 11, 2014
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... Read More

How to determine who is considered a covered entity under HIPAA

September 11, 2014
Check out this chart CMS has put out for a guidance on hot to determine whether an organization or individual is a covered entity under the Administration Simplification provisions of HIPAA.          Covered Entity Charts... Read More

Don't Let the New ICD-10 Catch You Off Guard

September 11, 2014
The Center for Medicare and Medicaid Services (CMS) has approved the final version for the new ICD-10-CM and ICD-10 PCS. Until coders and billers convert to this new ICD-10-CM coding system on October 1st, 2014 (now 2015), they will continue to use the ICD-9-CM codes and CPT/HCPCS codes. Howeve... Read More

CMS-gov E-Health information

September 11, 2014
Are you keeping up with Medicare's E-health news and updates. Keep informed, information related to Medicare's E-Health programs can be viewed here. (Click Here) E-Health includes: E-Prescribing Electronic Health Records Personal Health Records EHR Incentive Programs  eRx ... Read More

ICD-10 Implementation Practices; Assign a Project Manger!

September 11, 2014
The new ICD-10 interim final rule is expected to be released in the near future by the Department of Health and Human Services (HHS).   It requires the use of ICD-10 beginning October 1, 2015. You will continue to use ICD-9 CM through September 30, 2015. Claims will not be accepted with IC... Read More

GP Modifier for Physio Therapy Services

September 11, 2014
The -GP modifier needs to be appended to physio-therapy codes when submitting Medicare claims. However, be aware of differing policies for different types of payers. Chiropractors typically use the following Physical Medicine codes from the CPT book: 97010 thru 97799 (except... Read More

Can Chiropractors Bill 99211?

September 11, 2014
This code would be used rarely in a chiropractic office.  99211 is a low complexity examination for an established patient.  It can be used by chiropractors, but in most instances, it is discouraged. The 99211 code, also known as the nurse's code, is not really made fo... Read More

Fill In Doctor: Locum Tenens

September 11, 2014
It is a common practice for a solo doctor to find someone to cover for them while they are away from the office for a temporary or extended period of time, such as medical leave, or vacation. Some offices fail to code properly for the services rendered by the “fill-in” doctor. When compl... Read More

EHR Incentive Programs: Exclusions and Hardship Exceptions

September 10, 2014
CMS offers exclusions and hardship exceptions for eligible professionals who face challenges in meeting meaningful use objectives that require that they and their patients have broadband access and Internet connectivity. Patients’ Access to BroadbandThe Secure Electronic Messaging m... Read More

Who in the World are my Business Associates?

September 03, 2014
The associates in the provider’s world and healthcare society are filled with loads of potential business associates and endless individual identifiable health information.  We have had so many questions about business associates I thought I would go to the source and put together some i... Read More

Do I Need Error and Omissions (E&O) Insurance for My Billing Company?

September 03, 2014
Do I Need Error and Omissions (E&O) Insurance for My Billing Company? Having a billing company for the past 20 years, has been a great journey, 20 years ago it was called a Home-Based Business, today it is called a Corporation, more for protection and liability reasons. Over the years Medical b... Read More

Face-to-Face Encounter Requirement for Certain Durable Medical Equipment

September 03, 2014
The law requires that a physician must document that a physician, nurse practitioner, physician assistant or clinical nurse specialist has had a face-to-face encounter with the patient. The encounter must occur within the 6 months before the order is written for the DME. On September 9, 2013, the C... Read More

CMS announced a settlement request to Inpatient hospitals!

September 02, 2014
ATTENTION In-Patient Hospitals CMS has announced a settlement request to Inpatient hospitals for claims in appeal status! Due to the unprecedented growth in claim appeals the demand continues to exceed Medicare’s available resources. CMS has made an offer in hopes of quickly reducing inpatien... Read More

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