Coding – Page 6 – CRN Healthcare Solutions

HMA Pays $260 M for False Billing and Kickbacks

September 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Health Management Associates, LLC (HMA), a hospital chain that has its headquarters in Naples, Florida will be paying over $260 million to avoid criminal and civil claims associated with a scheme to defraud the government of the United States. In this… For more, read here: AAPC Blog

Analysis: AMA Responds to E/M Proposal

September 6, 2018September 7, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The AMA sent a letter to the Administrator of CMS on August 27, 2018 with signatures from most of the medical societies and state medical societies with comments on the CMS proposal for the “Patients Over Paperwork” initiative. AMA Loves Paperwork Red… For more, read here: AAPC Blog

E/M Changes May Hit Podiatry and Teaching Attestation

August 22, 2018August 29, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The Centers for Medicare & Medicaid Services (CMS) physician fee schedule proposed rule has some new Part B specific codes for Podiatry Evaluation and Management (E/M) services as well as some modification to Teaching Physician Attestation Rules f… For more, read here: AAPC Blog

CMS Proposes Add-on Codes for E/M Services

August 20, 2018August 29, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The Centers for Medicare & Medicaid Services (CMS) is proposing three new HCPCS Level II add-on codes to be used specifically with evaluation and management (E/M) codes, which would also be revised to create a single rate of $93 for established patients (99212-99215) and a single rate of $135 for new pa… For more, read here: AAPC Blog

Changing the Way Medicare Pays Doctors

August 6, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Besides taking a machete to E/M reimbursement and the way Medicare looks at E/M services, the current administration has proposed some large changes in the way Medicare pays doctors. They have also proposed ways that hospital facilities disclose prices to patients, providing more transpa… For more, read here: AAPC Blog

E/M: 2019 Proposed Physician Fee Schedule – Next Steps

July 17, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Proposed changes in the Medicare Physician Fee Schedule (MPFS) for 2019 will change proposed reimbursement single evaluation and management (E/M) rates. Here’s a way for medical coders to see how much the new routes may affect your workplace’s … For more, read here: AAPC Blog

CMS Proposes a Single E/M Payment, Streamlined Doc Requirements

July 13, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The Federal Register scheduled for publication on July 27, 2018 will include a proposal for a single E/M payment for new outpatient services, and a different single E/M payment for established outpatient E/M services, regardless of the E/M level subm… For more, read here: AAPC Blog

How to Document E/M with Counseling and Coordinating Care

July 2, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

The only case when time may be used as the overriding factor in determining an evaluation and management (E/M) level is when counseling and/or coordinating care dominates the encounter, which means that the time expended on counseling and/or coordinat… For more, read here: AAPC Blog

Modifiers 52 and 53 vs. 73 and 74

June 13, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Modifier 52, Reduced Services and Modifier 53, Discontinued Procedure apply to physician services while Modifiers 73 and 74, Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia and Disc… For more, read here: AAPC Blog

Audiology Technician Billing

June 4, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Medicare stipulates precise requirements for billing audiology technicians’ services. As outlined in the Centers for Medicare & Medicaid Services’ (CMS) Transmittal 84 in February 2008, these requirements are distinct from those governing audiolog… For more, read here: AAPC Blog