Medical Billing and Coding Healthcare Blog

The Centers for Medicare & Medicaid Services has published its latest Medicare Quarterly Provider Compliance Newsletter, which provides guidance to address medical billing errors.

The newsletter is designed to identify common billing errors and other erroneous activities when dealing with the Medicare Fee-For- Service (FFS) Program.

Topics discussed in the October 2016 issue include the following:

  • Transluminal Balloon Angioplasty, Venous
  • Endovenous Ablation Therapy of Incompetent Vein
  • Blepharoplasty
  • Transurethral Resection of the Prostate

CMS provides background on the procedure, the cause(s) of the most improper payments, examples of how providers fail to bill properly, recommendations on how healthcare professionals can avoid improper payments and resources.

To access the October 2016 issue, click here.

The American Medical Association has issued a new Current Procedural Terminology (CPT) code for influenza vaccine Flucelvax.

The code — CPT 90674 — went into effect on August 1, 2016, for Medicare claims. However, as the Centers for Medicare & Medicaid Services states, Medicare claims processing systems will not be able to accept the new code until January 1, 2017.

Until the start of the new year, you may hold claims containing CPT 90674. Alternatively, Medicare Administrative Contractors (MACs) may direct use of a Not Other Classified (NOC) code to allow billing for the vaccine for dates of service on or after August 1, 2016, and before January 1, 2017.

CMS advises providers to check with their MAC for this information and other interim billing instructions.

Note: If you bill institutional claims, CMS noted that code CPT 90674 will be implemented on February 20, 2017.

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