The American Chiropractic Association (ACA) has published several new resources intended to help doctors of chiropractic (DCs) with proper implementation of Medicare’s Physician Quality Reporting System (PQRS). Eligible professionals who do not satisfactorily report data on quality measures for covered professional services will be subject to a PQRS negative payment adjustment (pdf) beginning in 2015. […]
Understanding How to Code and Bill for Transcatheter Mitral Valve Repair
In August 2014, the Centers for Medicare & Medicaid Services issued a National Coverage Determination (NCD) for transcatheter mitral valve repair (TMVR). This decision memo stated CMS would cover TMVR for mitral regurgitation (MR) under Coverage with Evidence Development (CED) for the treatment of MR when furnished for an FDA-approved indication with an FDA-approved device […]
Medicare Issues Reminder on Submission of Duplicate Claims
The Centers for Medicare & Medicaid Services (CMS) has issued a reminder about submitting duplicate claims to Medicare in a recent issue of the Medicare Quarterly Provider Compliance Newsletter (pdf). As Medicare notes, submitting duplicate claims for the same service encounter is inappropriate. Medicare does not make payment for duplicate claims that a provider may […]
Certified Medical Coder Salaries Now Average More Than $50,000
Salaries for certified medical coding professionals increased an average of 8.4% in 2014 to $50,775 annually, according to the results of the 2014 annual coder salary survey conducted by AAPC. More than 14,000 medical coders responded to the survey. Other highlights include the following: Coders with a bachelor’s degree earned an average of $54,522 in […]
CMS Releases New Version of Ambulance Fee Schedule Fact Sheet
The Centers for Medicare & Medicaid Services has released the latest version of its Medicare Learning Network “Ambulance Fee Schedule” fact sheet. This fact sheet is intended to provide education on the Ambulance Fee Schedule and ambulance billing. It includes information on the following: Medicare ambulance transport benefit; types of ambulance providers and suppliers to […]
Highlights of Policy and Payment Changes to the Medicare Physician Fee Schedule for 2015
The Centers for Medicare & Medicaid Services (CMS) recently issued its final rule that updates payment policies and rates for services furnished under the Medicare Physician Fee Schedule (PFS) in 2015. Here are some of the highlights of the policy and payment changes for services furnished under the PFS. Screening and diagnostic digital mammography. Until […]
Coding Guidance for Smoking Cessation Counseling
The American Psychiatric Association provides a two-page resource discussing procedure coding for smoking cessation counseling. There are a number of different procedure codes that can be used to describe services provided to encourage changes in behavior of individuals who use tobacco. The resource identifies the CPT and HCPCS codes that describe smoking/tobacco cessation counseling, as […]
#1 Physician Complaint About Payers: Claims Denials
In a new survey by Medscape, physicians identified denial of claims as the worst experience they have with insurance companies. According to the survey’s results, published in the “Insurer Ratings Report 2014,” claims denials were the most frequently as well as the most intensively described negative experience. Medscape also asked physicians to rate payers on […]
Free Orthopedic ICD-10 Resources
The Centers for Medicare & Medicaid Services, as part of its “Road to 10: The Small Physician Practice’s Route to ICD-10,” offers a series of valuable, free ICD-10 resources for orthopedic surgeons. These resources include the following: 1. Common orthopedics codes. An illustrative sample of high-impact diagnosis codes related to common conditions that you may […]
Medicare’s Final 2015 ASC Payment Rule Adds 11 Spine Procedures to Payable List
The Centers for Medicare & Medicaid Services (CMS) has released its final 2015 ambulatory surgery center (ASC) payment rule (pdf), according to an ASC Association report. In the final rule, CMS finalized the addition of the following 11 spine codes to the ASC-payable list: 22551 — Neck spine fuse&remov bel c2 22554 — Neck spine […]