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Latest articles

CMS and HHS Tighten Enrollment Rules and Increase Penalties
October 1st, 2019 - Wyn Staheli, Director of Research
This ruling impacts what providers and suppliers are required to disclose to be considered eligible to participate in Medicare, Medicaid, and Children's Health Insurance Program (CHIP). The original proposed rule came out in 2016 and this final rule will go into effect on November 4, 2019. There have been known problems ...
Federal Workers Compensation Information
October 1st, 2019 - Wyn Staheli, Director of Research
When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program. Division of Federal Employees' Compensation (DFEC) website Division of Federal Employees' Compensation (DFEC) provider ...
E-Health is a Big Deal in 2020
September 16th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
The new 2020 CPT codes are on the way! We are going to see 248 new codes, 71 deletions, and 75 revisions. Health monitoring and e-visits are getting attention; 6 new codes play a vital part in patients taking a part in their care from their own home. New patient-initiated ...
Chiropractic 2020 Codes Changes Are Here
September 9th, 2019 - Wyn Staheli, Director of Research
There are some interesting coding changes which chiropractic offices will want to know about. Are codes that you are billing changing?
Q/A: Is the Functional Rating Index by Evidence-Based Chiropractic Valid?
September 9th, 2019 - Wyn Staheli, Director of Research
Question Is the Functional Rating Index, from the Institute of Evidence-Based Chiropractic, valid and acceptable? Or do we have to use Oswestry and NDI? Answer You can use any outcome assessment questionnaire that has been normalized and vetted for the target population and can be scored so you can compare the results from ...

Editors choice articles

So How Do I Get Paid for This? APC, OPPS, IPPS, DRG?
August 21st, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
You know how to find a procedure code and you may even know how to do the procedure, but where does the reimbursement come from?  It seems to be a mystery to many of us, so let's clear up some common confusion and review some of the main reimbursement systems.  One of the ...
Are You Aware of Medicare Advantage Plans Timely Filing Rules?
August 20th, 2019 - Aimee Wilcox
The Medicare Fee for Service (FFS) program (Traditional or Original Medicare) has a timely filing requirement; a clean claim for services rendered must be received within one year of the date of service or risk payment denial. As any company who has billed Medicare services can attest, the one-year timely filing ...
Understanding Payment Indicators
August 19th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Understanding how payment works with Medicare payment indicators and the impact a modifier has on payment is vital to pricing. Even if you are not billing Medicare, most carriers follow Medicare's policies for participating and non-participating rules.  Here is an article from Regence on their policy statement, describing the rules ...
Healthcare Common Procedure Coding System (HCPCS)
August 13th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
There are three main code sets and Healthcare Common Procedure Coding System (HCPCS), is the third most common code set used. They are often called Level II codes and are used to report non-physician products supplies and procedures not found in CPT, such as ambulance services, DME, drugs, orthotics, supplies, ...
Will Medicare Change Their Rules Regarding Coverage of Services Provided by a Chiropractor?
August 13th, 2019 - Wyn Staheli, Director of Research
Two separate pieces of legislation introduced in the House of Representatives (H.R. 2883 and H.R. 3654) have the potential to change some of Medicare’s policies regarding doctors of chiropractic. Find out what these two bills are all about and how they could affect Medicare policies.

Latest questions/posts

CPT 82948
1st    Sep 18th, 2019 - NAHAR, SHAMSU

hospital codes
   Sep 17th, 2019 - nate0922 7 

CPT code 97760
   Sep 17th, 2019 - RedKat  

Both COPD and Bronchiectasis?
1st    Sep 16th, 2019 - JackKline

CPT 93925
   Aug 20th, 2019 - stomach1 3 

Code for physical activity counseling
1st    Aug 9th, 2019 - Corley

CPT 29799
   Jul 30th, 2019 - RedKat  

Physician ESRD Capitation Billing
   Jul 11th, 2019 - anitac

CPT 99441
   Jul 9th, 2019 - abbyakinleye 9 

UNNA boot application
1st    Jul 3rd, 2019 - cmarsh

CPT Code for Repositioning of endothelial keratoplasty
   Jun 12th, 2019 - yml3768 31 

CPT for Long Term Acute Care Hospital
1st    Jun 11th, 2019 - nwettach

51701
   Jun 10th, 2019 - AMat    2 

UnitedHealthcare to Discontinue Coverage of Consultations
   May 28th, 2019 - msimmons11   

MDM in Table B
   May 17th, 2019 - damills    3 

Level 3 & Level 4 Hospital Consults
   May 15th, 2019 - nate0922 7 

Bone Stimulator Billable Amount
1st    May 8th, 2019 - pattybth

Podiatry - CPT codes 99222 & 99223
   May 1st, 2019 - daystarjj 4 

Coding for respiratory tract infections and other conditions during pregnancy
1st    Apr 25th, 2019 - Paramesh

Medicare Annual Wellness Visit in the Nursing Home Setting
1st    Apr 22nd, 2019 - staracres


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