Book a FREE Training Consult TODAY Learn More

Blog

Blog

Telemedicine Originating Site

Medicare (CMS) Telemedicine Originating Site

What does Medicare consider an originating site for Telemedicine services? Medicare (CMS [Centers for Medicare and Medicaid Services]) has some guidance to help you identify what might qualify as an originating site. You will need to verify with your other payers if you are dealing with someone other than Medicare. The Medicare originating site locations […]

Published Date: February 9, 2017

ICD-10 Combination Codes

Use ICD-10 Combination Codes to Avoid Denials, Speed Payments

With more than 71,000 ICD-10 codes this year, your diagnosis coding can be more confusing than ever. One key to limiting that confusion is to know how to easily identify and when to use combination codes. These codes link symptoms, manifestations or complications with a particular diagnosis. Use them correctly, and you’ve got medical necessity […]

Published Date: February 7, 2017

Qualified Medical Beneficiary Indicator

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) utilize an indicator of Qualified Medicare Beneficiary (QMB) status to the Medicare Fee-For-Service claims processing systems. The QMB program assists low-income Medicare beneficiaries, who, by federal law, pay no Medicare deductibles, copays, or coinsurance. CMS instructs MACs to create a new beneficiary […]

Published Date: February 3, 2017

Changes To The National Coordination of Benefits Agreement

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) implement changes to the National Coordination of Benefits Agreement (COBA) crossover process according to a Social Security Number Removal Initiative (SSNRI) undertaken by CMS consistent with the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA) of 2015. CMS provides […]

Published Date: February 3, 2017

Addition Of Influenza Vaccine Code To CWF

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) handle payments and make changes to the Common Working File (CWF) for the addition of influenza virus vaccine code 90682. Contractors must accept claims with dates of service on or after July 1, 2017. Contractors must make payments, adjust claims and otherwise […]

Published Date: February 3, 2017

Using A Five Digit County Code

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) use a five digit county code for the purposes of implementing an out migration adjustment that used to be done manually. The county code will go on inpatient and outpatient Provider Specific Files (PSF). A Pricer will calculate appropriate wage index for […]

Published Date: February 3, 2017

Update To Internet Only Manual

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) publish an update to IOM, Medicare Claims Processing Manual with a revision. Contractors shall delete the Type of Bill codes list, which is outdated. Contractors shall be aware of the IOM Chapter 25 changes. Full Transmittal: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3709CP.pdf Subject: Internet Only Manual (IOM) […]

Published Date: February 3, 2017

Using The New National Correct Coding Initiative

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) utilize a new National Correct Coding Initiative (NCCI) set of procedure to procedure edits (PTP) known as Version 23.1, which will be effective April 1, 2017, available via the CMS Data Center (CDC), for correct payment of Medicare Part B claims. Contractors […]

Published Date: February 3, 2017

NPP Services Supervision

NPP Services Supervision

Is there a difference between the supervising and collaborating physicians? Yes, there is a huge difference. The supervising physician has got to be where you can pull them in and grab ahold of them. This would be whoever is in the clinic that day. The collaborating physician would be the physician who set up the […]

Published Date: February 1, 2017

MIPS vs. APM

Free Tool: MIPS vs. APM Decision Tree for 2017 MACRA

The first, and potentially most important, decision you’ll make as you start your 2017 MACRA compliance journey is to determine which program you fall under — MIPS or Advanced APMs. Make the wrong decision, and you can be hit by reductions in your future Medicare payments. Make the right decision, and you could qualify for […]

Published Date: January 31, 2017