PGM Billing, one of the nation’s leading medical billing companies, is profiled in a recent report by Becker’s Hospital Review. The report identifies companies that provide revenue cycle management solutions specific to the healthcare industry. PGM’s profile reads as follows: “Physicians Group Management (Lyndhurst, N.J.). PGM, founded in 1981, offers physician billing services, facility billing […]
CMS: New Drug Testing Laboratory Codes Editing Incorrectly
The Centers for Medicare & Medicaid Services (CMS) has announced it discovered systems errors affecting claims with new drug testing laboratory codes (HCPCS codes G0477 through G0483) with dates of service on or after January 1, 2016. If you are affected, CMS states that your Medicare Administrative Contractor (MAC) will be holding these claims until […]
Free Oncology Billing and Coding Resource: 2016 Update From ASCO
The American Society of Clinical Oncology (ASCO) has published a free, downloadable resource that identifies oncology billing and coding updates for 2016. Topics discussed include the following: New CPT codes (99415 and 99416) Radiation oncology CPT updates New HCPCS codes (J8655, J7508 and J7503) Deleted HCPCS codes Filgrastim HCPCS updates Chemotherapy drugs (replacements) HCPCS codes […]
Improve Your Coding in 2016: 5 Tools to Use
Proper medical coding is critical for many reasons. They include receiving proper payment for services rendered, limiting denials and maintaining compliance with payor rules. Throughout 2015, PGM Billing launched a number of practice management tools that help ensure proper coding. These tools are free to access and use, and can be shared with coworkers and […]
4 ICD-10 Changes to the Laboratory National Coverage Determination Edit Software for January 2016
The Centers for Medicare & Medicaid Services has announced four changes that will be included in the January 2016 quarterly release of the edit module for clinical diagnostic laboratory services. The changes being made to the National Coverage Determinations (NCD) code lists as follows: Addition of ICD-10-CM codes N131 and N132 to the list of […]
CMS Issues 2016 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment
The Centers for Medicare & Medicaid Services (CMS) has issued a new change request (CR) that should be of interest to clinical diagnostic laboratories that submit claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries. CR 9465 provides instructions for the calendar year (CY) 2016 clinical laboratory fee schedule, mapping for new […]
PGM and ICANotes Publish Whitepaper on Outsourced Billing for Mental Health
PGM Billing, a leading provider of integrated physicians billing services, practice management and revenue cycle management services, and ICANotes, a comprehensive electronic healthcare records solution for psychiatry and behavioral health professionals, have published a whitepaper discussing the benefits of the PGM and ICANotes’ billing platform for mental health professionals. The whitepaper, titled “The Case for […]
Medicare Increases Payments for Incomplete Colonoscopies
The Centers for Medicare & Medicaid Services (CMS) has announced it is revising the method for calculating payment for incomplete colonoscopies billed with modifier -53. Effective January 1, 2016, the new payment rates will apply when modifier -53 (discontinued procedure) is appended to Current Procedural Terminology (CPT) codes 44388, 45378, G0105 and G0121. As CMS […]
CMS Issues 2016 HCPCS Update
The Centers for Medicare & Medicaid Services (CMS) has posted its final Level II HCPCS application determinations for 2016. Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies and services not included in the CPT-4 codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, […]
OIG Report: $76 Million in Questionable Medicare Payments for Chiropractic Services
The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) recently analyzed Medicare paid claims for chiropractic services from 2013. A major finding: In 2013, $76 million in Medicare payments for chiropractic services were questionable, with Medicare inappropriately paying $21 million for chiropractic services that lacked a primary diagnosis covered […]