AAPC News

Diabetes Practice Options: Avoid Simple Mistakes When Coding …

josh — Thu, 24 May 2012 17:07:37 +0000

Fraud is always a concern in practice management settings and medical coders and billers need to take note on all fraud-related suspicions. AAPC member Jen de Zayas, CPC, CPC-H wrote about fraud in the latest Diabetes Practice Options newsletter. “Some perfectly legitimate physicians are audited when they forget to include, or don’t know about, a... Read more »

Scrubs and Suits: CMS’ New Requirements for Supervision …

josh — Tue, 22 May 2012 20:26:38 +0000

“CMS has issued requirements for physician supervision of diagnostic tests performed in a non-hospital setting,” wrote AAPC member Terry Fletcher, CPC, CCC, CEMC, CCS-P, CCS, CMSCS, CMC in a recent article for Scrubs and Suits. The article highlights several areas within the cardiology arena and specifically the three levels of supervision as defined by Medicare–General,... Read more »

AAPC’s 2013 Medical Coding Books Now Available for Pre-Order

josh — Tue, 22 May 2012 16:24:57 +0000

SALT LAKE CITY—May 21, 2012— AAPC (www.aapc.com), the nation’s largest training and credentialing association for the business side of medicine, announced the launch of their 2013 medical coding books pre-order sale. This marks the fourth consecutive year that prices have not increased and the second year in a row where prices have been reduced, keeping... Read more »

Health Imagining: ICD-10 at a Glance

josh — Fri, 18 May 2012 23:11:11 +0000

The ICD-10 changeover, regardless of implementation date, will not be a quick fix. We know that the process will take time and a great deal of effort. “Practices can’t simply buy a new code book and be ready the next day,” says Rhonda Buckholtz, CPC, CPMA, CPC-I, CENTC, CGSC, COBGC, CPEDC vice president of ICD-10... Read more »

Just Coding: Crossing the divide

josh — Tue, 15 May 2012 21:31:40 +0000

Do coders and physicians speak the same language? With ICD-10 looming that potential language barrier could widen. Just Coding recently discussed this topic highlighting presentations from the AAPC National Conference in Las Vegas last April. VP of ICD-10 training and education Rhonda Buckholtz and Dr. Joseph Nichols, MD were the presenters during a conference session,... Read more »

HFMA Revenue Cycle Strategist: Training Coders to Transition to ICD-10

josh — Mon, 14 May 2012 17:03:30 +0000

With ICD-10 still looming on the horizon, many of us have begun the process of implementation, but there is still much to be done. Some have not begun either and AAPC ICD-10 trainer Jackie Stack, CPC, CPC-I, BSHA wrote that “taking a medical terminology or anatomy and pathophysiology course is a great way to prepare... Read more »

What Docs Like EHR the Best?

brad — Fri, 11 May 2012 16:27:45 +0000

Health research firm KLAS says internal medicine doctors report a satisfaction of 7.6 out of 9 for their chosen electronic health record (EHR) systems, making them the group of physicians most satisfied with their EHR. The Utah-based research group’s study finds family physicians are nearly as satisfied with their EHR systems. Oncologists and ophthalmologists are... Read more »

Look Out for Ultrasound Gel Recall

john — Fri, 11 May 2012 16:27:05 +0000

U.S. marshals, acting on the authority of the Food and Drug Administration (FDA), seized several lots of tainted ultrasound transmission gel from a Newark, N.J. pharmaceutical company, Medical News Today reports. The gel is used to enhance the transmission of ultrasound waves. The materials seized from Pharmaceutical Innovations, Inc. included all lots of Other-Sonic Generic Ultrasound... Read more »

Highmark Now Novitas

renee — Fri, 11 May 2012 16:26:31 +0000

Part A/B Medicare administrative contractor (MAC) Highmark Medicare Services (HMS) is now Novitas Solutions, Inc. Along with the name change, providers in the new jurisdiction H may have to update their electronic funds transfer (EFT) paperwork and their understanding of local coverage determinations (LCDs). Novitas will process Medicare fee-for-service (FFS) claims and other administrative services... Read more »

Lithotripsy Payment Cut 21 Percent

renee — Fri, 11 May 2012 16:25:42 +0000

Physicians will be paid considerably less for lithotripsy procedures performed on Medicare patients this year than was first thought, according to the Ambulatory Surgery Center Association (ASCA). The national membership association reported on their website May 3 that the November 2011 payment rate for CPT® code 50590 Fragmenting of kidney stones was incorrect. Upon detecting the... Read more »

New Occurrence Code for Reporting Date of Death

renee — Fri, 11 May 2012 16:24:05 +0000

Effective Oct. 1, 2012, Medicare systems will expect to see on claims a new occurrence code for reporting the date a patient dies. Providers and suppliers who bill fiscal intermediaries (FIs), regional home health intermediaries (RHHIs), or Part A/B Medicare administrative contractors (MACs) for services provided to Medicare beneficiaries should include occurrence code 55 and... Read more »

Temporary Workaround Billing for Organ Donor Complications

michelle — Fri, 11 May 2012 16:23:02 +0000

Medicare will now separately pay for complication services for a person who donates an organ to a Medicare beneficiary, according to the Centers for Medicare & Medicaid Services (CMS) change request (CR) 7816. With customary claims, the patient is always the beneficiary, so the patient relationship has always been a one-to-one match. When a person... Read more »

CMS Covers New Technology for Heart Valve Damage

michelle — Fri, 11 May 2012 16:21:46 +0000

The Centers for Medicare & Medicaid Services (CMS) now covers transcatheter aortic valve replacement (TAVR) for Medicare patients, under certain conditions. According to CMS, coverage for TAVR is approved under Coverage with Evidence Development (CED) only for the treatment of severe symptomatic aortic valve stenosis when all of the following five conditions are met: The procedure is... Read more »

Sleep Medicine Docs Get Their Own Specialty Code

renee — Fri, 11 May 2012 16:20:54 +0000

At long last, Medicare is giving physicians who specialize in sleep medicine a little recognition by giving them their own specialty code. The Centers for Medicare & Medicaid Services (CMS) makes new specialty code CØ official in transmittal 2462. The new code is effective April 1, 2012. Sleep medicine doctors can self-designate their specialty on the Medicare... Read more »

NHIC Adds 95930 Coverage

renee — Fri, 11 May 2012 16:19:24 +0000

NHIC, Corp.’s “April 2012 Ophthalmology Optometry Billing Guide” includes a single, yet important, revision. Under the heading “Evoked Response Tests – NCD,” on page 10, the jurisdiction 14 Part B Medicare administrative contractor (MAC) has added coverage for CPT® procedure code 95930 Visual evoked potential (VEP) testing central nervous system, checkerboard or flash. NHIC, Corp. says in... Read more »

Check Claims History Before Billing G0443

renee — Fri, 11 May 2012 16:18:30 +0000

Among the many new preventive services now covered under Medicare is screening and behavioral counseling interventions in primary care to reduce alcohol misuse. To be reimbursed for providing these services to Medicare beneficiaries, you’ll need to carefully follow the instructions. For example, before you submit a claim for G0443 Brief face-to-face behavioral counseling for alcohol... Read more »

Current Status of Version 5010: Just a Call Away

renee — Fri, 11 May 2012 16:17:55 +0000

Implementation of the Health Information Portability and Accountability Act (HIPAA) version 5010 standard, originally expected to be implemented at the beginning of 2012, was extended to April 1, and then again to July 1 to accommodate providers and payers that had not successfully tested and implemented the claim guidelines. June 30 most likely will be the... Read more »

PECOS: Medicare Referral Rules Change

brad — Fri, 11 May 2012 16:17:08 +0000

Provider Enrollment, Chain and Ownership System (PECOS) rules finalized by the Centers for Medicare & Medicaid Services (CMS) will make it easier for physicians to refer patients to specialists. The PECOS rules, published April 27 in the Federal Register, loosen proposed rules regarding referrals to specialists, freeing providers and Medicare patients from referrals in most... Read more »

Dawn of Sunshine Act Postponed to 2013

brad — Fri, 11 May 2012 16:16:12 +0000

The Centers for Medicare & Medicaid Services (CMS) is postponing until 2013 the collection of data mandated by the Physician Payments Sunshine Act. CMS missed the implementation deadline of October 2011, and instead released draft regulations that solicited strong reactions from stakeholders. Part of the health care reform law, the law is intended to shed... Read more »

Primary Care Docs May See Pay Raise

brad — Fri, 11 May 2012 16:15:29 +0000

Primary care physicians could receive a pay raise bringing Medicaid primary care service fees in line with those paid by Medicare. The proposed boost would be in effect for calendar years 2013 and 2014. States would receive a total of more than $11 billion in new funds to bolster their Medicaid primary care delivery systems,... Read more »