CMS Proposes Payment Changes to Endoscopic Sinus Codes

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 Related Posts:CMS Proposes Add-on Codes for E/M ServicesSpecial Rules Apply to Endoscopic Sinus SurgeriesNo Changes to E/M Payment Until at Least 2021Auditing Postoperative Sinus DebridementsCMS Proposes a Single E/M Payment, Streamlined Doc…

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Getting Inspire Therapy for Sleep Apnea Covered

Obstructive sleep apnea causes those who suffer from it to sleep poorly and always feel tired. Obstructive sleep apnea is also indicative for heart Inspire® therapy is a promising alternative to traditional treatment options for sleep apnea, but getting it covered under insurance is not a given. For more, read here: AAPC Blog Related Posts:When Non-Covered and Covered Procedures Are Performed

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Billing 95165 Is Nothing to Sneeze At

The professional service of preparation and provision of antigens for allergen immunotherapy — reported using CPT® 95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple … For more, read here: AAPC Blog Related Posts:How Many Units of 95165 Can You Bill, Really?HMA Pays $260 M for False Billing and KickbacksRequirements for Reporting Allergy Services Are…Michigan Surgeon Accused of $60M Billing FraudIncident-to Billing May Be Eliminated2 Tips for Billing a Physician Assistant as…

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Auditing Postoperative Sinus Debridements

An auditor asked the question of postoperative sinus debridements while discussing functional endoscopic sinus surgery (FESS). It was asked if postoperative debridements are coded and chargeable when a septoplasty or a turbinate procedure is performed… For more, read here: AAPC Blog Related Posts:CMS Proposes Payment Changes to Endoscopic Sinus CodesSpecial Rules Apply to Endoscopic Sinus Surgeries

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Audiology Technician Billing

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 Related Posts:Billing 95165 Is Nothing to Sneeze AtHMA Pays $260 M for False Billing and KickbacksIncident-to Billing May Be Eliminated2 Tips for Billing a Physician Assistant as…Michigan Surgeon Accused of $60M Billing Fraud

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Coding 3 or 4 Sinuses Using FESS Codes

A lot of people have been asking questions about how to code FESS surgeries with the new combination codes when three or four sinuses are operated on. Sinus and FESS We have been expecting an AMA CPT® Assistant article with guidance this year, but no … For more, read here: AAPC Blog Related Posts:Will Computer-Assisted Coding Make Coders Obsolete?Coding NewsCMS Proposes Payment Changes to Endoscopic Sinus CodesCMS Proposes Add-on Codes for E/M ServicesOIG to Audit Risk Adjustment Coding

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Advocacy to Change 31241’s Pay to Outpatient

Advocates are seeking to convince the Centers for Medicare & Medicaid Services (CMS) to pay for outpatient care of patients receiving 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery. The new code for 2018 was assigned… For more, read here: AAPC Blog Related Posts:Medicare Part D Prescription Drug Model to Change in 2020

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Medical Coding Tissue Transfer or Rearrangement

I often see incorrect medical coding for “flaps”, which were adjacent tissue transfers, 14000-14350. Coders do not always understand that you can only code for the closure of the primary and secondary defect, but not for each flap that is created. Sur… For more, read here: AAPC Blog Related Posts:OIG to Audit Risk Adjustment CodingWill Computer-Assisted Coding Make Coders Obsolete?New Jersey’s New Law Aimed Eliminates “Surprise”…Coding News

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AMA Updates Flap and Turbinectomy Codes For 2018

Other than the FESS CPT® changes for 2018, there are a few more CPT® updates to note for the upcoming year. The first changes have to do with Flaps (skin and/or deep tissues). Additional instructions were added to these codes, stating: “The regions … For more, read here: AAPC Blog Related Posts:CMS Proposes Payment Changes to Endoscopic Sinus CodesCMS Proposes Add-on Codes for E/M ServicesHealthcare Job Growth Greatest in 2018

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