Last September, CMS published a Medicare Learning Network brochure on mental health services. Included in this brochure is an informative section discussing same-day billing guidelines. Note: The information in this section, and publication, applies only to the Medicare Fee-For-Service Program, also known as Original Medicare. According to CMS, integration of the following services is an […]
What Does a Medical Laboratory Technician Do?
With the improvement in the medical health care facilities, there has been a phenomenal increase in the average life span of a person. There has been a steep increase in the diagnostic facilities and this has also spawned an increase in the need of Medical Lab Technician. The scope for a Medical Lab Technician is […]
Top Billed Chiropractic Codes: ICD-9 to ICD-10 Conversion
Priority Health, a Michigan-based health plan, provides a valuable, free resource for chiropractors. The one-page resource identifies top billed chiropractic ICD-9 codes, along with their general description, and then provides the corresponding ICD-10 diagnosis code(s). Oct. 1, 2015 was recently confirmed as the new ICD-10 transition compliance date for healthcare providers. The Priority Health resource […]
CMS Assigns Physician Specialty Designation for Interventional Cardiology
The Centers for Medicare & Medicaid Services has granted a new specialty designation for interventional cardiology, according to numerous reports, including a Society for Cardiovascular Angiography and Interventions press release. The new specialty code will allow CMS to distinguish an interventional cardiologist from a clinical cardiologist when billing Medicare for services. The designation is expected […]
Free Chiropractic Billing Resource: American Chiropractic Association’s FAQs About Medicare Program
The American Chiropractic Association provides a free, valuable Medicare coding and billing resource you can access regardless of whether you are a member of ACA. On its website, ACA answers about 20 chiropractic questions about the Medicare program. These questions include the following: Are we allowed to bill Medicare patients directly (i.e., not billing Medicare) […]
CMS Updates MLN Matters Article on Proper Modifier -59 Use
CMS has recently updated an MLN Matters article to clarify the proper use of modifier -59. There are two revisions made to MLN Matters article number SE1418 (pdf). One revision corrects a code in one of the examples provided to help guide use of modifier -59 while the other revision is an editorial change in […]
Most Frequently Reported Claims Denial Reason Codes by Payer
Here are the most frequently reported claim adjustment reason codes (CARC) for a claims denial by payer, according to data from the American Medical Association’s National Health Insurer Report Card for years 2008-2013 that address denials. Aetna — CARC 96: Non-covered charge(s). (37.2% of denials) Anthem — CARC 204: Service/equipment/drug is not covered under the […]
Dermatology World Column Discusses Billing Medicare for ‘Incident To’ Services
A column in the latest issue of Dermatology World, the official magazine of the American Academy of Dermatology Association, focuses on billing Medicare for “incident to” services. CMS defines “incident to” services as services furnished incident to physician professional services in the physician’s office (whether located in a separate office suite or within an institution) […]
Medicare Report: Modifier -51 Misuse Leading to Underpayments
Medicare has identified frequent misuse of modifier -51 that is leading to underpayments. This is according to a recent issue of Medicare Quarterly Provider Compliance Newsletter (pdf), a newsletter from CMS developed to help providers understand the major findings identified by Medicare administrative contractors, recovery auditors and other governmental organizations, such as the Office of […]
4 Top Trends in Pathology Billing and Coding
Labs nationwide have faced significant billing and coding challenges over the past few years. These challenges are likely indicative of trends labs can expect to face in the coming years. Here is a quick snapshot of four of the top lab billing and coding trends. 1. Reduced reimbursement. Reimbursement cuts have hit providers of most […]