The American Chiropractic Association has published a new infographic focused in ICD-10 myths. The infographic, which can be viewed by clicking here, shares several myths, including: Doctors should not waste time on ICD-10 implementation. A bill, if passed, would allow for a transition period of “dual reporting,” allowing organizations to bill both ICD-9 and ICD-10 […]
Medicare Identifies Improper Payments Associated With Extracorporeal Shock Wave Lithotripsy
Medicare has disclosed the primary cause for improper payments associated with extracorporeal shock wave lithotripsy (ESWL). 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 […]
What is Revenue Cycle Management?
PGM Billing provides a number of services to physician practices, ambulatory surgery centers, labs and other providers. One of these services is revenue cycle management, or RCM. When organizations ask what PGM can do for them and we mention our extensive experience with providing revenue cycle management services, it’s not unusual to hear the question, […]
CMS Discusses Payment Errors Associated With Co-Surgeon Modifier -62
The Centers for Medicare and Medicaid Services (CMS) recently released a Medicare Learning Network podcast intended to clarify CMS’s existing policy regarding payments errors because of a failure to apply properly the co-surgeon modifier -62, when two or more surgeons of different specialties participate in one operative session and each separately submit claims to Medicare. […]
CMS Provides Clarification on the Use of Modifiers When Billing “Wrong Surgery on a Patient”
The Centers for Medicare and Medicaid Services (CMS) recently released a Medicare Learning Network podcast which was intended to clarify the correct use of certain HCPCS modifiers, specifically when billing for wrong surgery on a patient. CMS discussed the HCPCS modifier -PC (Wrong Surgery on Patient), which was established in CR6405 (pdf), along with two […]
FAQs About CPT Coding and Reimbursement for Psychiatrists
Following substantial changes to the current procedural terminology (CPT) psychiatry codes, the American Psychiatric Association updated its frequently asked questions (FAQs) about coding and reimbursement for psychiatrists. The update occurred in March. If your organization performs mental health billing and coding, these FAQs may be a valuable resource to review. The following are the questions […]
ICD-10 Allergy and Immunology Coding Resources
The American Academy of Allergy, Asthma & Immunology (AAAAI) offers a robust collection of information and resources to designed to help practicing allergists/immunologists properly follow ICD-10 rules. As the AAAAI notes, if your practice performs allergy billing and coding, the conversion from ICD-9 to ICD-10 was rather seamless for some diagnoses but more complicated for […]
17 FAQs About Billing Medicare for Chronic Care Management Services
The Centers for Medicare & Medicaid Services (CMS) has released a new, special MLN Matters article (pdf) on chronic care management (CCM) services frequently asked questions. Here are the 17 FAQs — and their answers provided by CMS — regarding billing CCM services to the physician fee schedule (PFS) under CPT code 99490. 1. CPT […]
Free ICD-10 Coding Resources: ICD-10 Conversion Tool and Practice Quizzes
The conversion to ICD-10 is less than five months away. With the start date for ICD-10 set for Oct. 1, 2015, it is imperative for coding professionals using ICD-9 to begin practicing the new ICD-10 coding conventions. There are approximately 68,000 ICD-10 codes, compared to 14,000 ICD-9 codes. The good news is that approximately 78% […]
Medicare Identifies Most Common Causes of Improper Payments for ESRD-Related Services
Medicare has determined that the majority of the improper payments for end stage renal disease (ESRD)-related services were due to insufficient documentation. This is according to a recent issue of Medicare Quarterly Provider Compliance Newsletter (pdf), a newsletter from CMS developed to help providers to avoid common billing errors and other erroneous activities when dealing […]