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 […]
8 Statistics on EHR Adoption
Here are eight interesting statistics on electronic health records software adoption in physician offices, according to SK&A’s annual “Physician Office Usage of Electronic Health Records Software” (pdf) report. 1. From 2013 to 2014, physician office usage of electronic health records increased more than 10 percentage points in solo and smaller practices. 2. Overall EHR adoption […]
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 […]
History of Chiropractic Care
The roots of chiropractic care can be traced all the way back to the beginning of recorded time. Writings from China and Greece written in 2700 B.C. and 1500 B.C. mention spinal manipulation and the maneuvering of the lower extremities to ease low back pain. Hippocrates, the Greek physician, who lived from 460 to 357 […]
Medicare Increases Scrutiny of Anesthesia Billing
Medicare is increasing its scrutiny of anesthesia billing as a result of recovery auditors finding a high percentage of errors involving the incorrect use of the HCPCS modifiers for anesthesia. These errors are specifically associated with situations when anesthesia was provided by a CRNA and anesthesiologist without a 50% reduction as per Medicare guidelines involving […]