CMS Increases Definitive Drug Testing Reimbursement

The Centers for Medicare & Medicaid Services (CMS) will increase reimbursement for toxicology drug confirmation codes in 2017. Background For 2016, CMS implemented four new HCPCS G codes for definitive drug testing: G0480 G0481 G0482 G0483 CMS priced these codes using a crosswalking fo rmula. The first two tests performed were paid at the full […]

Gastroenterology Billing Compliance: Enteral Infusion Pumps

The Centers for Medicare & Medicaid Services (CMS) has released a video that contains guidance to help providers bill correctly for enteral infusion pumps. Medicare Part B covers enteral nutrition supplies and equipment (feeding pump) under the prosthetic device benefit. The two-minute video discusses Medicare coverage criteria for enteral infusion pumps and the four pieces […]

Laboratory Medical Billing Compliance Fact Sheet for Urine Drug Screening

The Centers for Medicare & Medicaid Services (CMS) has released a new provider compliance fact sheet concerning laboratory billing. More specifically, the fact sheet concerns requisitions or orders for urine drug screening laboratory tests. The fact sheet noted that a HHS report revealed “laboratory tests – other,” which includes drug screenings, had an improper payment […]

CMS Releases Laboratory Billing Compliance Fact Sheet

The Centers for Medicare & Medicaid Services (CMS) has released a new provider compliance fact sheet concerning laboratory medical billing. The fact sheet noted that a HHS report revealed “laboratory tests – other” (e.g., urine drug screening, medication assays, genetic tests, tissues examination, blood tests) had an improper payment rate of 39 percent, with a […]

New CPT Code Issued for Influenza Billing

The American Medical Association has issued a new Current Procedural Terminology (CPT) code for influenza vaccine Flucelvax. The code — CPT 90674 — went into effect on August 1, 2016, for Medicare claims. However, as the Centers for Medicare & Medicaid Services states, Medicare claims processing systems will not be able to accept the new […]

CMS Publishes Video on Psychotherapy and Psychiatry Billing

The Centers for Medicare & Medicaid Services (CMS) has published a video on provider compliance relating to psychotherapy and psychiatry medical billing. The video includes pointers to properly submit documentation for these services, more specifically the use of add-on codes when billing for same day evaluation and management and psychotherapy services, and three factors needed […]

CMS Issues Reminder About Reporting Medicare Enrollment Changes

The Centers for Medicare & Medicaid Services (CMS) has issued a reminder to Medicare-enrolled providers concerning reporting changes in enrollment information. Failure to comply with the requirements to report changes in Medicare enrollment information could result in the revocation of Medicare billing privileges. All physicians, non-physician practitioners (e.g., physician assistants, nurse practitioners, clinical nurse specialists, […]