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Latest articles

Importance of Depression Screenings
August 16th, 2018 - Wyn Staheli, Director of Research
Why would a chiropractor be concerned about depression screenings when you aren’t trained to be a mental health provider? The answer lies in patient outcomes. Many quality care organizations recommend depression screenings for patients with a chronic condition. According to The National Institute of Mental Health, “People with other chronic ...
Using Modifiers 96 and 97
August 16th, 2018 - Wyn Staheli, Director of Research
The Affordable Care Act (ACA) requires coverage of certain essential health benefits (EHBs), two of which are rehabilitative and habilitative services and devices. Since the ACA did not define these terms or specify coverage requirements, it is left up to individual states to create benchmark plans to determine coverage requirements. ...
Provide Proof of a Qualified Professional with QPro!
August 1st, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
QPro - Announces the Launch of an Innovative Testing Site! Innovation is paving the way once again! Unlike other certification bodies, QPro does not certify the ability to pass a test but instead verifies members qualifications are proven. Test online using real-life coding resources and coding books commonly used in the office setting. Who can Benefit ...
CMS Proposes Changes to Evaluation & Management Requirements
July 25th, 2018 - Wyn Staheli, Director of Research
It is no secret that providers have long argued that E/M coding is burdensome and does not truly reflect the services provided. This fact is acknowledged by CMS with the following statement "Prior attempts to revise the E/M guidelines were unsuccessful or resulted in additional complexity due to lack of ...
Patients Over Paperwork?! We have Great News!
July 18th, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Spend more time with patients and less time documenting? Great Concept! Document meaningful information? Sound good? CMS is proposing just that! CMS released a new proposal July 12, 2018, focused on streamlining clinician billing and expanding access to high-quality care. The goal is to improve and restore the doctor-patient relationship, modernize Medicare ...

Editors choice articles

Patients Over Paperwork?! We have Great News!
July 18th, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Spend more time with patients and less time documenting? Great Concept! Document meaningful information? Sound good? CMS is proposing just that! CMS released a new proposal July 12, 2018, focused on streamlining clinician billing and expanding access to high-quality care. The goal is to improve and restore the doctor-patient relationship, modernize Medicare ...
Attention Providers - Please Make Time to Read this Letter
July 17th, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
In an effort to show CMS is committed to changing the rules to accommodate their providers CMS released a letter to Doctors of Medicare Beneficiaries. The letter offers encouragement and a promise to reduce the burden of unnecessary rules and requirements. The letter states “President Trump has made it clear that ...
Dual Medicare-Medicaid Billing Problems
July 12th, 2018 - Wyn Staheli, Director of Research
It is important to keep in mind that Medicaid is run at a state level so there can be some differences when it comes to coverage. However, the rules regarding balance billing of covered services is set at the federal level. The law states (emphasis added): A state plan must provide ...
The Money in MIPS
June 15th, 2018 - Diana Strubler
Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), recently announced that 91% participated in the first year of the Quality Payment Program (QPP), barely squeaking by their goal of 90%....
Health Care Fraud - Don’t Do It!
July 31st, 2017 - Chris Woolstenhulme, CPC, CMRS
If you wonder if what you are doing is fraud, DON’T DO IT! The government takes this extremely serious. I don't need to tell you this.  I have often been apprehensive about making a mistake and I wonder, will it be fraud? Will I spend time in jail for accidentally sending in a duplicate ...

Latest questions/posts

MDM credit in Table B
   Aug 17th, 2018 - damills 1 

Grouping of mutually exclusive CPt4 in IR DRG
1st    Aug 17th, 2018 - Hhiba

Denial in question
   Aug 15th, 2018 - alleegator13

Incident To Billing
   Aug 14th, 2018 - dlstoner512 1 

Reimbursement Question for J2785 - Injection, regadenoson, 0.1 mg
1st    Aug 13th, 2018 - Jaywalkz

CPT 61510 and 61518- multiple tumors
   Aug 12th, 2018 - LBAROGIANIS 250 

ICD-10 - Help
   Aug 7th, 2018 - precod 10 

Repair Code vs Flap Code
   Aug 2nd, 2018 - sharris

Dexcom G5 CPT
   Jul 13th, 2018 - precod 10 

medical practice reimbursement issues
1st    Jul 11th, 2018 - johntimber

I need codes for private lab tests to report to Medicare and AARP
1st    Jun 28th, 2018 - maryaloftus

Rewording prior question on CPT 93000
   Jun 27th, 2018 - sschwartz 3 

Aetna denial on E/M codes
   Jun 27th, 2018 - gowri.tina

Pouchoscopy with dilation of anus with biopsy?
1st    Jun 25th, 2018 - mlh2000ku

VP tie off
   Jun 22nd, 2018 - lizzg

Axillary artery cutdown
1st    Jun 20th, 2018 - dll

Mesh removal in office
1st    Jun 13th, 2018 - Nikkibear

Initial patient eval with medical services
1st    Jun 12th, 2018 - Andrea58

CPT code for Colon hydrotherapy
1st    Jun 7th, 2018 - daltonl

ERCP Coding
   May 31st, 2018 - Roxanne W    1 


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