What Guidelines will Medicare follow for Pneumoccal Vaccine?
As you may recall, in November we reported that although the Advisory Committee on Immunization Practices (ACIP) had updated its guidelines regarding pneumococcal vaccines, Medicare had not changed its...
View ArticleAre you billing medicaid correctly since the ACA Increased Reimbursment ended?
Because the ACA PCP rate increase ended on December 31, 2014, billing instructions have been updated for Vaccinations and Nurse Practitioners. Nurse Practitioner billing During the increased PCP rates...
View ArticleCMS Instructions do not Follow CPT Guidelines
Have you researched a coding subject to then find differing answers? Wisconsin Physician Services (WPS) has recently reiterated that there are times when the Current Procedural Terminology (CPT)...
View ArticleMedicare Holding 2015 Claims
On November 13, 2014, the CY 2015 Medicare Physician Fee Schedule (MPFS) final rule was published in the Federal Register. In order to implement corrections to technical errors discovered after...
View ArticleWill you get paid for Screening for Hepatitis C Virus (HCV) in Adults?
According to MLNMatters MM871 (implemented January 1, 2015), effective June 2, 2014, CMS began to cover screening for HCV with the appropriate U.S. Food and Drug Administration (FDA) approved/cleared...
View ArticleUnited Healthcare Adopts ACOG Hysterectomy Opinion
Beginning April 6, 2015, United Healthcare will use ACOG’s Committee Opinion 444, Choosing the Route of Hysterectomy for Benign Disease. Per ACOG, “evidence demonstrates that, in general, vaginal...
View ArticleIncrease your Revenue with Chronic Care Management Services
Are your physicians billing chronic care management? If not, read further to learn how your physicians or non-physician practitioners’ (NPP) maybe able to increase their revenue. This work is more...
View ArticleConsultation Codes No longer Covered by Indiana Medicaid
The Indiana Health Coverage Programs (IHCP) has decided to follow Medicare’s direction and no longer cover Consultation Codes 99241-99245 and 99251-99255. This coverage change also applies to...
View ArticleConfused about Modifier 78 and 79
Modifier 78 and 79 have been around for years now, but are you using them correctly for all payors? United Healthcare and Anthem Medicare Advantage plans as of 2015 are adopting the CMS rule for...
View ArticleAnthem Delays in Payment due to New Member Identification Prefixes for 2015
With the first of the new year and insurance carrier changes, you can almost always expect that the member insurance cards and /or policy numbers will change. If you are not asking your patients to see...
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