At one time, Centers for Medicare & Medicaid Services (CMS) found that approximately 85% of improper payments relating to the billing of implantable automatic defibrillators were due to insufficient documentation. The figure was determined through a Comprehensive Error Rate Testing (CERT) program’s special study of Healthcare Common Procedure Coding System (HCPCS) code 33249 (Insertion or […]
January 2023 Bulletin: Billing Reminders Part 2: Secondary Payers
Billing Reminders for the New Year – Part 2 Medicare Secondary Payer: Sometimes, a member will have Medicare as a secondary payer. In this case, it is mandatory that the Medicare Secondary Payer (MSP) code be entered on the claim form. This can be found on Availity or the Medicare web portal. Common MSP codes […]
January 2023 Bulletin: Billing Reminders Part 1 – Eligibility & Benefits
Billing Reminders for the New Year – Part 1 Eligibility & Benefits: With a new year comes new insurance policies for patients across the country. It is important to remember that many patients change plans at the start of a new year so verifying benefits and eligibility is a must. While some patients keep the […]
December 2022 Bulletin – COVID-19 Vaccine Updates
COVID-19 Vaccine Updates The holiday season has the potential to bring a new wave of COVID-19, so understanding what vaccines are right for you is vital to keep you and your family members safe. As of December 22, 2022, the Centers for Disease Control and Prevention (CDC) provided updates on what you need to know […]
December 2022 Bulletin – It’s Deductible Season!
It’s Deductible Season! The end of one year brings the beginning of a new one and that means annual deductibles have been reset for 2023. As a result, patients will be responsible for higher balances and insurance payments will be lower for the first quarter of the year. To better understand what a patient may […]
November Bulletin – Medicare Part B & Tetanus Vaccines
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 […]