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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
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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
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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
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Complex Care Management

In 2017 Get Paid for the Complex Care Management You Provide

In 2016, Medicare added chronic care management (CCM, 99490) to its list of reimbursable codes. Starting Jan. 1, the agency is adding complex CCM services (99487-99489) to that list as well. But there are specific rules you must follow to get the payment you deserve. Most likely, you’re already providing these much needed extra services […]
Published Date: December 6, 2016
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Overtime Payment Changes

Federal Court Puts Hold on Overtime Payment Changes

The Fair Labor Standards Act (FLSA) overtime pay changes going into effect Dec. 1, previously covered in the Sept. 13 CompliancePop blog, are on hold. The U.S. District Court for Eastern Texas placed a nationwide hold on the new salary threshold of $47,476 for the FLSA overtime exemption, which postpones the rule’s implementation. This means […]
Published Date: November 29, 2016
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Moderate Sedation Codes

Moderate Sedation Codes in 2017 Easier and No More Bulls-Eyes

If you bill for moderate sedation, things just got a little easier for you next year. CPT® 2017 has changed how you code these services for more than 400 procedures. You’ll notice there’s something missing in your 2017 CPT manual. All those bulls-eyes that indicated a code could include moderate sedation are gone. And the […]
Published Date: November 29, 2016
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Incident to and 15% Payup

Proximity Unlocks Incident to and 15% Payup

We recently held a webinar on billing nonphysician practitioner (NPP) services incident to the physician. And you wouldn’t believe the number of questions that came out of that session. This is certainly not a new topic, but there continues to be a great deal of confusion surrounding it. And many of the questions had to […]
Published Date: November 22, 2016
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NPs/PAs Overtime Exempt

Are Your NPs/PAs Overtime Exempt? Better Check Before Dec. 1

If you pay your mid-level providers a salary and think they’re automatically exempt from the overtime rules under the Fair Labor Standards Act (FLSA), you had better make sure they meet the new labor law salary requirement that takes effect Dec. 1 — or you might be in for a rude surprise. In fact, an […]
Published Date: November 15, 2016
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Unspecified Code Denials

4 Steps to Head Off Unspecified Code Denials

As if diagnosis coding isn’t hard enough, ICD-10-CM includes a whole group of unspecified codes that will almost ensure your claims end up in the denial pile. But there are a few steps you can take early on that can prevent this from happening. ICD-10 offers a great deal more specificity, and payers expect you […]
Published Date: November 8, 2016
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