Chronic care management

Check 5 Capabilities to Bill Chronic Care Management

Whether it’s diabetes, arthritis, or heart disease, an increasing number of your patients are likely to have at least one chronic condition, especially as the Baby Boomer population continues to age. Over the past few years, CMS has expanded coverage for chronic care management. The catch? Before you can bill—and get paid-for chronic care management […]
ICD-10-CM Vaping Coding

CDC Notice: 4 Rules for ICD-10-CM Vaping Coding

Due to the epidemic of vaping related injuries and deaths, the CDC has released ICD-10-CM Vaping Coding Guidance. Based on what is now known about vaping or e-cigarette-related health conditions, the update contains official diagnosis coding guidance for encounters related to e-cigarette or vaping product use associated lung injury (EVALI). The CDC is investigating the […]
OIG Urine Drug Test

OIG Watch List: Protect Payments from Urine Drug Test Audits

The Office of Inspector General (OIG) added to its Workplan items that contractors will audit or evaluate with a more critical eye. If you bill for urine drug test or speech-language pathology services to Medicare beneficiaries, now’s the time to weigh your compliance risk and fix any issues. OIG Scrutinizes Urine Drug Test, Speech-Language Pathology […]
Well woman exam

6 Easy Steps to Unlock Your Well Woman Exams Pay Up

Getting reimbursed for preventive well woman exam claims is tricky – not all third-party payers reimburse for these services and the coverage rules vary for the payers that do. You can’t afford to mess up the ABN or the allowed codes. Remove barriers to get the reimbursement you deserve by following a handy step-by-step guide. […]
Medicare Diabetes Prevention Program MDPP

CMS Releases 2020 Payment Rates for Medicare Diabetes Prevention Program MDPP

CMS has released the 2020 payment rates for HCPCS codes for the Medicare Diabetes Prevention Program (MDPP). A provider can receive payments of varying amounts close to $700 per beneficiary. New MDPP 2020 payment rates go into effect Jan. 1. While the rate change is minimal, every dollar makes a difference towards an ounce of […]
CPT code 99211

Ask an Expert: Does Blood Pressure Check Qualify for CPT Code 99211?

QUESTION: Can you bill CPT code 99211 for a blood pressure check by the nurse? The patient did not see the doctor. Anonymous, Salt Lake City, UT ANSWER: You may bill CPT code 99211 for a blood pressure evaluation for an established patient whose physician requested a follow-up visit to check blood pressure. CPT code […]
CPT Code 59400

Global Billing Growing: Capture Charges Beyond CPT Code 59400 for Bundled Care

Insurance trends are shifting from fee-for-service models to global billing structures including in the area of maternity care pricing: a flat rate fee for (almost) all services rendered to cover the entire pregnancy billed with one code such as CPT code 59400. Correctly including what is part of a global billing model – and what […]
burnout ICD-10-CM code Z73.0

Perk Up Your Office With Tips to Bust Burnout: ICD-10-CM Code Z73.0

If you’re feeling especially snippy to your staff or can barely summon the energy to get through your work day, you could be struggling from burn out. This syndrome is increasing so quickly in our modern times that it now has its own diagnosis for burnout: ICD-10-CM code Z73.0. ICD-11 includes a section for burnout […]

ICD-10-CM Code Changes Broken Down by Specialty

Knowing what ICD-10-CM code changes you need to focus on updating this Fall can be like finding a needle a haystack. ICD-10-CM code changes for 2020 include 324 code changes (273 new, 21 deleted, and 30 revised codes) – and you need to hone in on the ones you need to educate staff on, watch out […]
coding remote patient monitoring smart watch reading

Maximize Billable Opportunities for Coding Remote Patient Monitoring

CMS won’t release the 2020 Medicare Physician Fee Schedule final rule until later this fall, but that doesn’t mean you should wait to shore up your reimbursement for coding remote patient monitoring based on the proposed rule. Released in July, the proposed rule contains important clues about what you can expect next year. And even […]