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Latest articles

Transparency and Fees
August 15th, 2017 - Christine Taxin

More than any other industry, healthcare is almost notorious for its lack of price transparency. While patients generally know how much their copay will be and certainly how much their final bill turns out to be, few hospitals and practices publish the actual costs of their services prior to those ...

United HealthCare Ending Consultation Reimbursements: Effective October 1st, 2017
August 15th, 2017 - NAMAS

While Medicare discontinued payment allowance for consultation services (ranges 99241-99245 and 99251-99255) in January 2010, many commercial carriers have continued to cover these services. United Healthcare is now joining Medicare's opinion on consultation services. In the June 2017 edition of the United HealthCare Bulletin, United Healthcare has announced that effective October ...

Collect More Cash from Patients
August 11th, 2017 - Christine Taxin

One of the easiest things a practice can do to increase collections makes it easier for patients to pay by whatever method they have available at the time of the visit, says Christine Taxin Adjunct Professor at NYU Dental School and Owner of Links2Success.biz.

Cybersecurity - Are you sure you are secure?
August 4th, 2017 - Wyn Staheli

An article by Medical Economics highlights the June report of the Health Care Industry Cybersecurity Task Force. Their report confirmed once again that healthcare providers are not adequately addressing cybersecurity as part of the compliance programs. The threat of hackers is very real and providers need to ensure that they have taken ...

Proposed Telehealth Changes for 2018
August 4th, 2017 - Wyn Staheli

Medicare has proposed making some changes to policies regarding telehealth services. They are adding some new codes to their covered list of telehealth services and propose eliminating the requirement to use the GT modifier. Since many payers adopt similar policies, watch for further announcements...

Editors choice articles

Pre-op visits: True or False?
December 29th, 2015 - Codapedia Editor

Are the following statements true or false? • The PCP cannot be paid to do a pre-op assessment of a Medicare patient prior to surgery because of the new consult rules. • The surgeon can never be paid to do a pre-op visit if s/he is going to take the patient to surgery. • The...

Billing Incident to Services-Whose Number Should Be Used?
December 29th, 2015 - Seth Canterbury, CPC, ACS-EM

Should You Bill Incident to Services for a Medicare Patient Under The Number of the “Supervising Physician” or the “Ordering Physician”? This issue was first clarified in the preamble of the 11/1/01 Federal Register (available here on p. 23 of the file, p. 55267 of the...

Cloned E/M notes
December 29th, 2015 - Codapedia Editor

Have you ever read a physician office note and thought it was strangely familiar? Or, not just familiar but identical to another note? Well, Medicare contractors have noticed the same thing, and the Office of Inspector General has included this on their 2011 Work Plan. Medicare contractors have...

Cardiology Coding Unmasked - Part 2 Therapeutic Cardiology Procedures, CPT Codes (92980-92982; 92984; 92995-92996), Medical Necessity Issues (ICD-9-CM)
December 29th, 2015 - Nancy Maguire

92980 Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; single vessel 92981 Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; each additional...

Subsequent nursing home visits
December 29th, 2015 - Codapedia Editor

Subsequent nursing facility visits are reported with codes 99307--99310. These codes are defined as per day codes, and do not have new and established patient divisions. There are also initial nursing facility codes, which only a physician may use. A physician or NPP may use the subsequent...