Book a FREE Training Consult TODAY Learn More

Blog

Blog

Telemedicine Claim Denials

Avoid Telemedicine Claim Denials by Knowing Your Site

In 2017, the Centers for Medicare and Medicaid Services (CMS) has added even more services to its approved telemedicine list, and you can be sure that the agency will continue this trend in coming years. That’s great news for both your potential patients and your practice. But the coding is hardly straightforward, and you have […]
Published Date: January 24, 2017
Read More
Modifier Choice

Modifier Choice Key in Boosting Payments for Bilateral Procedures

If you report bilateral procedures — and most practices do — how you tell your payers that you performed the same services on both sides of the body depends greatly on the payer itself. But there are some general tools and strategies you can follow that will point you in the right direction, and help […]
Published Date: January 17, 2017
Read More
MIPSMACRA Quality Measures

Where Can I Find the MIPS/MACRA Quality Measures

MACRA’s new Merit-Based Incentive Payment System (MIPS) changes the way Medicare pays you. And unless you fully understand how to report your quality data under MIPS, your future Medicare payments will be significantly reduced (decreasing up to 4% initially, then later up to 9%). The bottom line is that your future Medicare payments will be […]
Published Date: January 13, 2017
Read More
CMS and MACRA

OIG Report Says CMS Still Has Work to Do on MACRA

Although you are expected to begin gathering data for the Medicare Access and CHIP Reauthorization Act (MACRA) in 2017, a recent report from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) indicated that there’s still more work to be done to ensure everyone has the tools and guidance necessary to […]
Published Date: January 3, 2017
Read More
MIPS Quality Measures

5 Strategies Help You Select Your MIPS Quality Measures

As you’re gearing up for 2017, selecting the best Quality measures to report under MIPS is essential for you to be able to achieve the highest possible Final Score. This is the only way to improve your chances to receive a positive Medicare payment adjustment rather than a reduction to your future revenues. Use these […]
Published Date: December 27, 2016
Read More
Medicare Claims Denied

Medicare Claims Denied For NCCI Edits

What do you do when an insurance payer denies a claim for NCCI edits, but it is contrary to the NCCI edits found on CMS’s website? Whose edit guidelines take precedence? When you are looking at NCCI verses a local coverage determination, the local coverage determination trumps the NCCI. One of the reasons for this […]
Published Date: December 22, 2016
Read More
Symptoms and Confirmed Diagnoses Codes

Know When to Code for Symptoms and Confirmed Diagnoses to Support Your Claims

When you’re assigning diagnoses for a patient encounter, if you have a confirmed diagnosis, that’s what you use. You don’t need to submit the patient’s signs and symptoms too. But there are times when you need both to support your claim to receive the reimbursement you deserve. When relying on signs and symptoms codes, there […]
Published Date: December 20, 2016
Read More
X Modifiers Over Modifier 59

When to Use X Modifiers Over Modifier 59

Consistent misuse and abuse of modifier 59 has put it on the Office of the Inspector General’s active radar. Meaning they are just waiting for you to slip up. To make matters worse, modifier 59 sub-modifiers (XE, XS, XP, XU) and varying carrier guidelines, make it even more difficult to get it right. In fact, […]
Published Date: December 20, 2016
Read More
MACRA Final Rule Deadline

MACRA Final Rule Deadline: Submit Your Comments by Dec. 19

Although the Centers for Medicare and Medicaid Services (CMS) released the final rule under the Medicare Access and CHIP Reauthorization Act (MACRA) back in October, it’s still looking for feedback in certain areas affected by the regulation. You can still provide feedback and suggestions, but your time if running out. You must submit your comments […]
Published Date: December 7, 2016
Read More