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Category: Billing

Billing Part of the Blog

Prevent Medicare Claims Denials in 2020

December 10, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Medicare has been issuing beneficiaries new member cards with Medicare Beneficiary Identifiers (MBI) in place of Social Security Numbers (SSNs) for more than two years. 2019 was a phase-in period when Medicare would accept either a beneficiary’s Socia… For more, read here: AAPC Blog

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Is Direct Primary Care the Answer?

December 5, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Direct primary care (DPC) is one of the newer forms of plans offered by primary care providers to their patient populations. Some see DPC as an alternative to traditional third-party payment for care and other more recent models such as concierge med… For more, read here: AAPC Blog

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OIG Uncovers Medicare Overpayments for Chronic Care Management Services

November 14, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Chronic care management (CCM) services are services that do not involve face-to-face patient/provider contact. The Centers for Medicare & Medicaid Services (CMS) implemented Medicare coverage for CCM in Jan. 1, 2015. There are very specific guid… For more, read here: AAPC Blog

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How Many Units of 95165 Can You Bill, Really?

September 30, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Three credible sources give three different answers, and only one is right. The definition for billing units of allergy serum preparation for patients was recently challenged by a colleague of mine who works in the allergy space. Are there limitations… For more, read here: AAPC Blog

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MDM – New Problem to Examiner or Patient?

September 26, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

When calculating an evaluation and management (E/M) level or auditing an E/M service, every Medicare Administrative Contractor (MAC) has always had the points assigned for a new problem under the Number of Diagnoses or Treatment Options based on a new… For more, read here: AAPC Blog

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Incident-to Billing May Be Eliminated

September 13, 2019September 14, 2019Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Incident-to billing for advanced practice providers (nurse practitioners, physician assistants, clinical nurse practitioners, nurse midwives, etc.) has been available to limited license practitioners s… For more, read here: AAPC Blog

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2 Tips for Billing a Physician Assistant as Assistant Surgeon

August 29, 2019September 3, 2019Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

A physician assistant (PA) serves as an assistant surgeon only to suture and close an incision. There is no documentation that the PA performed any other function to assist the primary surgeon during the surgery performed on the Medicare patient, suc… For more, read here: AAPC Blog

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CMS Proposes Payment Changes to Endoscopic Sinus Codes

August 12, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The Centers for Medicare & Medicaid Services (CMS) is proposing major payment changes to sinus endoscopy services. The 2020 Physician Fee Schedule (PFS) proposed rule includes the following excerpt: We are proposing to apply the special rule for m… For more, read here: AAPC Blog

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Anthem Changes Timely-Filing Deadlines

August 5, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Anthem has sent out a notice to all providers who have signed non-Medicare or Medicare Advantage contracts with them, stating: “Effective for all commercial and Medicare Advantage Professional Claims submitted to the plan on or after Oct. 1, … For more, read here: AAPC Blog

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Reporting Bilateral Services: Conflicting Information Causes Confusion

July 29, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Payer-specific rules — especially rules that vary for every claim — not only make collecting revenue difficult, but also add to the cost of collection of monies earned by the physicians. A blog clarifies Novitas’ instructions for reporting modifier … For more, read here: AAPC Blog

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