Bundling - Articles
E/M service prior to a screening colonoscopyDecember 29th, 2015 - Codapedia Editor
CMS does not pay for an Evaluation and Management service prior to a screening colonoscopy. If a patient calls or is sent from another physician to schedule a screening colonoscopy, do not bill any type of E/M service prior to the procedure. Some commercial carriers also follow this policy.
If...
Don’t expect to see payment any time soon for ‘telephone consults’October 15th, 2014 - Scott Kraft
Four new CPT® codes that got some attention when the 2014 CPT® changes were released late last year were a new E/M code series, 99446-99449, designed to be reported when a consulting provider offered a telephone or Internet E/M service that included a verbal and written report back to the...
2014 brings big volume of changes to CCI editsJanuary 30th, 2014 - Scott Kraft
Expect the biggest set of CCI changes you’ll see in 2014 to take effect on Jan. 1, as the edits are synched up to CPT® and HCPCS code changes that start next year.
There are 61,120 new edit pairs coming next year, along with 13,107 deletions and 137 modifier changes.
Many of the...
Modifier 59 no longer an option for repeat servicesOctober 1st, 2013 - Scott Kraft
If you’re starting to see denials when you append modifier 59 (distinct procedural service) to your claims that involve repeating the same procedure on the same date of service for the same patient, blame a change in Medicare claims policy that took effect on July 1, 2013.
Medicare...
Keeping Track of Your SurgeriesMarch 22nd, 2013 - Debra Sanders
When working my AR, I work my surgeries separately since that is my big money or bulk money. I want to make sure I get that money in as quickly as possible. For me, I created an excel spreadsheet. The columns are: DOS - PATIENT NAME/MRN - PROC NAME - CARRIER(S) - CPT® - MODIFIER - BILLED -...
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