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October 4th, 2021
Watch out for New ICD-10-CM Codes
Published October 4th, 2021|
New ICD Codes for: Low Back Pain, Cervicogenic Headache, Non-Radiographic Axial Spondyloarthritis (nr-axSpA), and Social Determinations of Health (SDOH). These codes became effective on October 1, 2021.
October 7th, 2020
Stay out of Trouble — Understand the Qualified Medicare Beneficiary (QMB) Program
Published October 7th, 2020|
To assist low-income Medicare beneficiaries, CMS created the Qualified Medicare Beneficiary (QMB) program; a Medicaid benefit which pays for Medicare deductibles, coinsurance, or copays for any Medicare-covered items and services for Medicare Part A, Part B, and Medicare Advantage (Part C). Providers/suppliers are prohibited from billing premiums and cost sharing to Medicare beneficiaries who are enrolled in QMB.
July 15th, 2020
Use the Correct Diagnosis Codes and Revenue Codes to Get Paid for PAD Rehab
Published July 15th, 2020|
The initial treatment in rehabilitation for patients suffering from Intermittent Claudication (IC) is Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD). Rehabilitation using SET involves the use of intermittent walking exercise, which alternates periods of walking to moderate-to-maximum claudication, with rest. When reporting 93668 for peripheral arterial disease rehabilitation the following ...
July 14th, 2020
Are NCCI Edits and Modifiers Just for Medicare?
Published July 14th, 2020|
The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...
April 8th, 2020
ICD-10-CM Official Coding and Reporting Guidelines Updated for COVID-19
Published April 8th, 2020|
The ICD-10-CM Official Coding and Reporting Guidelines have just been updated to include COVID reporting. Additional information beyond the previously released interim guidelines are included. These are the rules that should be followed for claims submission. The notice states that this is for April 1, 2020 through September 30, 2020.
March 31st, 2020
CMS-Coverage for Therapeutic Shoes for Individuals with Diabetes
Published March 31st, 2020|
Therapeutic shoes and inserts can play a vital role in a diabetic patient's health. Medicare may cover one pair every year and three pairs of custom inserts each calendar year if the patient qualifies and everything is handled correctly. Medicare Benefit Policy Manual explains what is needed for a person with diabetes to ...
March 26th, 2020
New Biofeedback Codes to replace 90911 Eff 2020-01-01
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), ...
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Advanced Beneficiary Notice of Noncoverage (ABN) Form Instructions ToolBilateral Surgeries: Claim SubmissionCommonly Used Medicare Modifiers - GA, GX, GY, GZDME Billing guideanceMedicare Part B Clinical Laboratory Fee ScheduleMLN - Billing and Payment Policies for Negative Pressure Wound Therapy (NPWT) Using a Disposable DeviceNoridian: Allowed Amount ReductionsPhysician Assistant (PA) Resources NoridianThe 8 Minute Rule - How Does It Work? PT Billing Services
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