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Latest articles

​​Polysomnography Services Under OIG Scrutiny
September 2nd, 2021 - Raquel Shumway
The OIG conducted a study dated June 2019 wherein they indicated that there were approximately $269 million in overpayments for polysomnography services for the period of 2014 through 2015. According to the OIG “These errors occurred because the CMS oversight of polysomnography services was insufficient to ensure that providers complied with Medicare requirements and to prevent payment of claims that didn’t meet those requirements.” So what are those requirements?
Medicare Advantage - The Fastest Growing Government-Funded Program Undergoing Multiple Fraud Investigations
August 16th, 2021 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
Medicare Advantage is the fastest growing form of government-funded healthcare and the rate of fraud within this segment has come under increased scrutiny. Funding is determined by the health status of each beneficiary; therefore, accurate coding based on detailed documentation makes the medical record vital to the process because some ...
Billing Dental Implants under Medical Coverage
August 12th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Implants can be costly to the patient and the provider, and it is crucial to understand how to bill a patient’s medical insurance to ensure there is adequate coverage for the best treatment. Implants are commonly billed in a dental office under a patient’s medical benefits.    Implants could be considered ...
New Codes for COVID Booster Vaccine & Monoclonal Antibody Products
August 10th, 2021 - Wyn Staheli, Director of Research
New codes have been announced for the COVID-19 booster vaccine, Novavax vaccine, and monoclonal antibody treatment.
Medicare's ABN Booklet Revised
July 29th, 2021 - Wyn Staheli, Director of Research
The “Medicare Advance Written Notices of Non-coverage” booklet, published by CMS’s Medicare Learning Network, was updated. This article discusses the changes to this booklet regarding the use of the ABN.

Editors choice articles

PCS Coding for Ankle Fracture - Look Deeper Into the Codes!
May 25th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Coding Lesions and Soft Tissue Excisions
April 29th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
COVID-19 Vaccines
March 10th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Not Following the Rules Costs Chiropractor $5 Million
September 1st, 2020 - Wyn Staheli, Director of Research
Is COVID-19 Causing Risk Adjustment “Gotcha’s”?
August 27th, 2020 - Wyn Staheli, Director of Research

Latest questions/posts

OTC or RX management in MDM
   Sep 17th, 2021 - sharris

Coding an E/M in place of a minor procedure that will not be paid
   Sep 16th, 2021 - sschwartz 4 

Medicare Part A billing for CPT 27447
1st    Jul 1st, 2021 - Boss Lady

Chiropractic Billing
1st    Jul 1st, 2021 - GCGchiro

integmentary biopsy
1st    Jun 18th, 2021 - Sunny_day3

ER/Hospitalist Professional Visits
1st    Jun 4th, 2021 - Dawna 1 

GA GY necessary on therapies not covered by Medicare?
1st    May 25th, 2021 - TammyC

97140 or 97124 and What Modifier?
1st    May 19th, 2021 - Anj 1 

Hello Everyone
1st    Apr 9th, 2021 - evopryseo 3 

chiropractic body region question
1st    Mar 15th, 2021 - GregoryH

biopsy of a perianal lesion/malignancy.
1st    Mar 10th, 2021 - btalley

Cardiothoracic Coders
   Feb 8th, 2021 - rdinaso    12  1 

water massage table
1st    Jan 27th, 2021 - KayC

Code G8730 rejection
1st    Jan 20th, 2021 - LEEs

Combination Codes
1st    Jan 7th, 2021 - BeckyR

Insurance Rejections For Medical Necessity - Can 2nd insurance be billed?
   Dec 29th, 2020 - sharris

If you know a procedure will be denied as cosmetic can an E/M be charged instead?
   Dec 1st, 2020 - sschwartz 4 

Elongated Toenails
   Nov 23rd, 2020 - sharris

Does National CPT Tracking exist?
1st    Nov 12th, 2020 - ShawnV

Bought out an Existing Practice
1st    Nov 5th, 2020 - SBerg

Nail Debridement vs Nail Trimming
   Nov 5th, 2020 - sharris

AT modifier use for spinal manipulation services
   Nov 2nd, 2020 - JBrooks 1 

GA modifier
1st    Sep 30th, 2020 - ACC

97110, 97530, 97012
1st    Sep 24th, 2020 - ChiroCasey

Manipulation Therapy & Habilitative/Rehabilitative Services
1st    Sep 22nd, 2020 - Coding&Thriving

99204
1st    Sep 18th, 2020 - smattiko

G-Codes
1st    Sep 8th, 2020 - MKramer

posterlateral fusion with inpatient stay
1st    Sep 4th, 2020 - Rambis

G0481
   Sep 3rd, 2020 - EXECD

Two modifiers
1st    Aug 21st, 2020 - sunshine1991


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