Internal Medicine - Articles

New Value-Based Payment Models for Primary Care (Primary Care First and Direct Contracting)
August 28th, 2020 - Jared Staheli
This article summarizes the new Medicare value-based payment models: Primary Care First and Direct Contracting.
Are NCCI Edits Just for Medicare?
July 14th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...
New CPT® Codes Approved for COVID-19 Antibody Identification
April 15th, 2020 - Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
On April 10, 2020, the American Medical Association approved and published a revision of code 86318 and added two new codes 86328 and 86769 for reporting Coronavirus [COVID-19] antibody testing.
LATEST COVID-19 INFORMATION FOR BILLING NON-FACE-TO-FACE SERVICES
March 26th, 2020 - Namas
Healthcare providers and the population at large are concerned about safe access to care considering the COVID-19 pandemic. As a result, we have received many inquiries this week about how to bill for “telehealth” services. Let’s first address that true telehealth services have some pretty stringent requirements from CMS, including that ...
Reporting the Health Effects of Vaping Now and in April 2020
December 19th, 2019 - Wyn Staheli, Director of Research
To report vaping related conditions/disorders, use the official CDC guidelines to ensure proper documentation of vaping related health conditions. There is also a new code that will become effective April 1, 2020.
The Facts of Critical Care
July 19th, 2019 - Namas
Critical care services remain to not only be an area of confusion for providers, coders, and auditors, but also a constant target for the carriers for audit. We can sit back and look at critical care and think of all of the ways the code descriptor and/or use could be ...
5 Ways to Minimize HIPAA Liabilities
July 12th, 2019 - BC Advantage
Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...
How to Properly Report Monitoring Patients Taking Blood-thinning Medications
June 18th, 2019 - Wyn Staheli, Director of Research
Codes 93792 and 93792, which were added effective January 1, 2019, have specific guidelines that need to be followed. This article provides some guidance and tips on properly reporting these services.
Home Oxygen Therapy
January 22nd, 2019 - Raquel Shumway
Home Oxygen Therapy Guidelines
Home Oxygen Therapy -- CMN for Oxygen
June 14th, 2018 - Raquel Shumway
The Certificate of Medical Necessity (CMN) for Oxygen is a required form that helps to document the medical necessity for oxygen therapy. It also documents other coverage criteria for the oxygen use. For payment on a home oxygen claim, the information in the supplier’s records or the patient’s medical record must be substantiated with the information in the CMN.

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