Laboratory Question for the Week of May 7, 2018
MedLearn Publishing
May 7, 2018
Are any of the specimen-collection codes paid separately by Medicare?
Are any of the specimen-collection codes paid separately by Medicare?
I have a follow-up question regarding the instructions given in the April 23 radiology question for the venous duplex scans of both the upper and lower extremities. The instructions were to add modifier -59 to the second 93970 to indicate that it was a different body area. This follows standard coding guidelines; however, we received a denial from our MAC (WPS or NGS) indicating we were to use modifier -76 based on CMS Transmittal 1702 (https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1702CP.pdf) which states:
For only those instances that involve more than one bilateral procedure and are medically necessary and appropriate, hospitals are advised to report the procedure code with a modifier -76 (repeat procedure or service by same physician) in order for the claim to process correctly. Appending modifier -76 to one of the reported bilateral HCPCS code indicates that the bilateral procedure or service was repeated on the same day for the same patient.
Is this information still applicable?
Level of care is increasingly becoming a source of payer utilization review denials It was widely recognized after the Centers for Medicare & Medicaid Services
Those involved in compliance will want to keep tabs on these changes with due concern. The Bipartisan Budget Act of 2018 (BiBA) was signed into
Providers must document the complexity of care for each and every patient. There is a standard misunderstanding of the utilization of time-based documentation and billing.
The importance of an effective outpatient CDI program cannot be overstated When working with a member of the sales force for a previous employer, I
Physician documentation issues during an audit go beyond CDI. EDITOR’S NOTE: This is the first in a four-part series that examines physician documentation issues as
Ten strategies for avoiding burnout are provided by the author. On any given day, if you walked into my home office, you might think you
Removal of the requirement, if adopted, becomes effective FY 2020. Our early review of the document and accompanying fact sheets has identified a number of
Can 31500 (intubation, endotracheal, emergency procedure) be reported with a ventilation code?
What is the proper way to bill Medicare for no-cost drugs since claims-processing edits prevent drug- administration charges from being billed when the claim does not contain a covered/billable drug charge?
When will CMS issue the new Medicare cards?
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