Improving the customer experience is no longer an idea that’s relegated to the retail or hospitality industries. Now, the idea has gained traction across many industries, including healthcare. For health plans, improving the customer experience and providing member-centric care helps drive member acquisition and retention and improve reimbursement (via a better STARS rating). With so […]
Since there are huge CPT coding updates for 2020, there are no new anesthesia codes. The newly proposed rule only includes new and revised codes for a few certain pain procedures. The rule provided for lowering of relative value units (RVU) for certain nerve injections codes which pay less in 2020. Some of the New Anesthesia […]
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 Social Security Number or their new MBI on claims. Starting Jan. 1, 2020, CMS will reject any Medicare claim Denials […]
Updates to the list of Therapy Services Code that sometimes or always describe therapy services under Medicare Part B go into effect Jan. 1, 2020. Make sure your coding and billing staff are aware of the following updates impacting coding for physical therapy, occupational therapy, and speech-language pathology service claims. Biofeedback Coding Two new biofeedback training CPT® […]
Guidance for using out-of-office BPs is not new. Medical evidence and clinical guidelines published over the last decade have showcased the importance of 24-hour ambulatory monitoring as the reference standard, and self-measured blood pressure monitoring (SMBP) as an acceptable alternative for obtaining BPs to diagnose and treat hypertension. And thanks to that abundance of research […]
Several CMS-designated permanent and product-specific J-codes recently went into effect, allowing three ophthalmology-minded pharmaceutical companies to expand reimbursement through commercial and Medicare insurance plans. J-codes were activated Oct. 1 for FDA-approved products manufactured by EyePoint Pharmaceuticals, Ocular Therapeutix and Omeros. In the past, J-codes were announced once a year; now, CMS is issuing certain J-codes […]
Among the upcoming changes to the CPT code set are updates to the radiology codes and medicine sections. This article discusses those updates, which take effect for all claims submitted on or after Jan 1. New CPT code Revised CPT code Resequenced CPT code Designated add-on CPT code Radiology Many “radiologic exam” radiology codes were […]
E&M codes are the most frequently used codes in any physician practice. Change is coming to the world of evaluation and management (E&M) services. With the Physician Fee Schedule Final Rule for 2020 now published, we know there are big changes to be expected in 2021. The good news is that there’s a year to […]
HCCs thrive on specificity and ICD-11 will provide a higher level of specificity than in ICD-10. For those of you who are HCC coding for hierarchical condition category (HCC) purposes, you know that HCCs are categories of related ICD-10 codes. Only selected significant conditions to drive a payment HCC coding. That means only conditions that […]
Three new HCPCS Level II G codes are added to the Medicare Telehealth Services list for Calendar Year (CY) 2020. These codes describe new bundled services for the treatment of opioid use disorders (OUD). The Centers for Medicare & Medicaid Services (CMS) states in the 2020 Physician Fee Schedule final rule, “By creating a separate bundled payment […]