Medicare Part B & Tetanus Vaccines Did you know that Medicare Part B only covers a tetanus vaccine when it’s given as the result of an injury or direct exposure? Medicare Part B does not cover tetanus vaccines when given preventatively. In fact, Medicare Part B doesn’t cover most preventative vaccines, so coding is important […]
August Bulletin – National Coverage Determination Updates
National Coverage Determination Updates Effective October 1, 2022, there will be several updates to the National Coverage Determination (NCD) guidelines that are implemented by the Centers for Medicare & Medicaid Services (CMS). The following NCDs are being updated to include changes for the 2023 fiscal year: NCD 150.3 Bone Density Studies NCD 160.18 Vagus Nerve […]
August Bulletin – Monkeypox Outbreak – What to Know
New Monkeypox Codes American Medical Association has published new CPT Codes in response to the Monkeypox virus outbreak. These codes are to be used to report lab testing and vaccinations and are effective as of July 26, 2022. Lab Code: When testing for monkeypox, labs should use code 87593 – Infectious agent detection by nucleic […]
June Bulletin – UnitedHealthcare Updates
UnitedHealthcare Updates UnitedHealthcare released plan updates for June 2022. All plan updates can be found here: UnitedHealthcare Community Genetic testing for hereditary cancer Cardiovascular disease risk tests More than a dozen medication updates UnitedHealthcare Commercial Macular degeneration treatment procedures Ambulance services Liposuction for lipedema UnitedHealthcare Medicare Advantage Cardiac procedures, including pacemakers and defibrillators Urinary and […]
April Bulletin – Google’s AI System Focuses on Healthcare
Google’s AI System Focuses on Healthcare In late March of 2022, Google announced that a new Artificial Intelligence (AI) program is focused on the treatment of cardiovascular conditions and the improvement of maternal health. Previously, Google created an AI system called ARDA that supports diabetic retinopathy screenings. This system is able to screen up to […]
April Bulletin – Insurance Updates
Insurance Updates Centers for Medicaid and Medicare Services (CMS) CMS updated and released a draft of the National Coverage Determinations (NCD) Guidelines for the Alzheimer’s disease treatment drug, Aduhelm. The coverage limitations could create challenges for those seeking treatment. The NCD process began in July of 2021 and at the time, the drug was highly […]
March Bulletin – CMS Announces New Place of Service Code
CMS Announces New Place of Service Code Effective January 1, 2022, a new place of service (POS) code became effective for use. The new POS Code, 10, indicates Telehealth services provided in the patient’s home. Prior to the creation of POS 10, the correct place of service code for all Telehealth visits was 2. Now, […]
March Bulletin – Insurance Company Updates
Insurance Company Updates Several insurance companies have made note-worthy updates to their billing policies. Superior HealthPlan Effective June 1, 2022, the criteria for the assessment and treatment of Attention Deficit Hyperactivity Disorder (ADHD) has been revised and updated. More than a dozen CPT codes have been deemed not medically necessary when billed with a sole […]
February Bulletin – The “No Surprise Act” Causes Confusion
Since the No Surprise Act (NSA) became effective on January 1, 2022, medical offices are experiencing trouble understanding and implanting the new requirements to remain compliant with the NSA guidelines. On January 20, 2022, the Medical Group Management Association (MGMA) called on the Centers for Medicare and Medicaid Services (CMS) and the US Department of […]
January Bulletin – Billing Reminders for the New Year
Billing Reminders for the New Year Eligibility & Benefits With a new year comes new insurance policies for patients across the nation. It is important to remember that many plans change at the start of a new year so verifying benefits and eligibility is key to proper billing. While some patients keep the same insurance […]