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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. ...
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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 ...
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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.
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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 ...
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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...
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Coding for Laser Therapy
November 21st, 2014
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | 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 ...
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Understanding TOS Discounts and DMPOs
November 21st, 2014
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | 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 ...
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Acupuncture ICD-10 Common Codes
October 17th, 2014
By Chris Woolstenhulme, QCC, CMCS, 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 ...
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Acupuncture ICD-10-CM Billing
October 16th, 2014
By Chris Woolstenhulme, QCC, CMCS, 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 ...
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Acupuncture and the Treatment of Headaches
October 9th, 2014
By Chris Woolstenhulme, QCC, CMCS, 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
...
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Medicare Definition of Timed Codes
September 15th, 2014
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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