On March 31, 2020, CMS announced further changes to their telehealth program in response to this unprecedented public health emergency (PHE). The announcement included far more information than is presented in this article which only summarizes the changes to telehealth. In fact, it does change a little of the information included in our March 31st webinar.
March 31, 2020 Presented by Evan M. Gwilliam, DC MBA BS CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC UPDATE: Please note that CMS wants you to use modifier 95 INSTEAD of Place of Service (POS) 02 for services rendered during this pandemic. “Report the POS code that would have…
Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and NCCI Policy Manual, which identify code pair edits. When performed on the same patient, on the same day, and by the same provider, the secondary code is considered an integral part of the primary code, and payment for …
CMS has made changes to their payment policies for reciprocal billing arrangements and Fee-For-Time compensation arrangements (formerly referred to as locum tenens arrangements). Providers need to be aware of these changes and update their policies as appropriate.
Section 1848(r)(4) of MACRA requires that claims submitted for items and services furnished by a physician or applicable practitioner on or after January 1, 2018, include codes for the following:
care episode groups
patient condition groups
patient relationship categories
Previously, CMS decided to use procedure code modifiers to report patient relationship codes on Medicare …
Watch Another quick tip from the ChiroCode HelpDesk – Plain Film Xray Penalty 2017. Even though this news comes from Medicare, who does not reimburse chiropractic physicians for x-rays, private payers nearly always follow their example. This represents the trend of X-ray reimbursement for all of healthcare.
Q: If a patient is treated with chiropractic manipulation and it is clinically appropriate but doesn’t qualify as medically necessary care, what is the proper way to communicate this when billing the insurance company for the service?
97110, Therapeutic Exercises, is one of the most commonly used CPT codes for Chiropractors. Unfortunately it is also misunderstood and misused far too often. For instance, did you know that it should not be reported with modifier 52, ever? Find out all you need to know about this code in the 2016 ChiroCode DeskBook Common Procedure Codes chapter.
Some doctors fail to code properly for a temporary doctor who is covering an office, or for mutual coverage with a colleague.
It is a common practice for doctors in solo practice to find someone to “cover” for them while they are away from the office for a temporary or extended period of time.
During such …
Separate Encounter, A Service That Is Distinct Because It Occurred During A Separate Encounter
Coding pairs are part of the National Correct Coding Initiative (NCCI) procedure to procedure edits
Documentation indicates the services were provided during separate patient/provider encounter
Use Modifier XE with the Column 2 procedure code in the NCCI files
Use Modifier XE only when there …