Over the last several months, the COVID-19 Pandemic has changed the course of the medical industry and The American Medical Association has approved new CPT codes for use during the COVID-19 public health emergency. Two new Category I CPT Codes were announced on September 8, 2020 for immediate use to meet the rapidly changing needs […]
UnitedHealthcare Extends National Public Health Emergency Temporary Program Changes
UnitedHealthcare recognizes that the persistence of COVID-19 cases across the country continues to have an impact on the healthcare system – both for COVID-19-related care as well as for regular preventive visits. To provide ongoing support to members and providers, UnitedHealthcare is extending many of the COVID-19 temporary program, process and coverage changes through Oct. […]
CMS Announces Additional HCPCS Codes Related to Lab Testing for Covid-19
On February 13, 2019 The Centers for Medicare & Medicaid Services issued an alert to ensure that patients have access to laboratory testing in response to the threat of Novel Coronavirus (COVID-19). CMS issued a new HCPCS code (U0001). This new code is for labs utilizing the Centers for Disease Control and Prevention (CDC) 2019 […]
Medicare Provides Guidance on Laboratory Services Consolidated Billing
When laboratory services are billed by providers other than the end-stage renal disease (ESRD) facility and the laboratory service furnished is designated as a service that is included in the ESRD Prospective Payment System (PPS), Medicare will reject or deny the claim. This is according to recent issue of Medicare Quarterly Provider Compliance Newsletter, a […]
Medicare Provides Guidance on Facet Joint Injection Billing
Medicare has found that insufficient documentation is a common cause for improper payments for facet joint injection procedures. This is according to a recent issue of Medicare Quarterly Provider Compliance Newsletter, a newsletter from CMS developed to help providers to avoid common billing errors and other erroneous activities when dealing with the Medicare Program. The […]
CMS Publishes January 2017 Medical Billing Errors Newsletter
The Centers for Medicare & Medicaid Services has published its latest Medicare Quarterly Provider Compliance Newsletter, which provides guidance to address medical billing process 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 January 2017 issue include the […]
Rhode Island Working to Address Surprise Medical Billing
Rhode Island has become the latest state to take steps in an effort to address the ongoing challenge of surprise bills for medical services. As the Providence Journal reports, state lawmakers are sponsoring legislation that would provide for a dispute resolution process for emergency services and surprise bills for medical services performed by nonparticipating (i.e., […]
CMS Increases Definitive Drug Testing Reimbursement
The Centers for Medicare & Medicaid Services (CMS) will increase reimbursement for toxicology drug confirmation codes in 2017. Background For 2016, CMS implemented four new HCPCS G codes for definitive drug testing: G0480 G0481 G0482 G0483 CMS priced these codes using a crosswalking fo rmula. The first two tests performed were paid at the full […]
Keep Out of Hot Water: Watch This False Claims Act Compliance Video
The Centers of Medicare & Medicaid Services (CMS) is reminding healthcare organizations about the importance of complying with the False Claims Act. False claims are not claims with innocent billing mistakes. Rather, providers know these claims are false. They include services that are: Not rendered Upcoded Not supported by the patien’’s medical record Part of […]
CMS Updates ESRD Prospective Payment System
The Centers for Medicare & Medicaid Services has issued a final rule that updates payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2017. The rule also finalizes new quality measures for dialysis facilities treating patients with ESRD. […]