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 […]
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 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 […]
Laboratory Medical Billing Compliance Fact Sheet for Urine Drug Screening
The Centers for Medicare & Medicaid Services (CMS) has released a new provider compliance fact sheet concerning laboratory billing. More specifically, the fact sheet concerns requisitions or orders for urine drug screening laboratory tests. The fact sheet noted that a HHS report revealed “laboratory tests – other,” which includes drug screenings, had an improper payment […]
Medical Billing Outsourcing on the Rise: 5 Contributing Factors
A new report by Grand View Research examines the growth of medical billing outsourcing. Grand View projects the outsourcing market to grow by more than 150% from 2015 to 2024. Here are five of the factors that will contribute to the significant growth, according to Grand View: Current systems in practice for managing revenue are […]
CMS Publishes Video on Psychotherapy and Psychiatry Billing
The Centers for Medicare & Medicaid Services (CMS) has published a video on provider compliance relating to psychotherapy and psychiatry medical billing. The video includes pointers to properly submit documentation for these services, more specifically the use of add-on codes when billing for same day evaluation and management and psychotherapy services, and three factors needed […]
CMS Releases Final Rule on Lab Billing and New Payment System
The Centers for Medicare & Medicaid Services (CMS) has released a final rule requiring laboratories performing clinical diagnostic laboratory tests to report the amounts paid by private insurers for laboratory tests. Medicare will then use these private insurer rates to calculate Medicare payment rates for laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS) […]