Did You Know? Global Surgery

This job isn't always easy

By: Lois McGruder-Jarman, CPC Director of Coding & Compliance, MedCycle Solutions CMS is currently focusing on 0-Day Global Surgery because it is supposed to include ROUTINE Evaluation and Management (E & M), so these procedures would normally be billed with modifier 25.   Current Procedures Under Review by CMS include: 11755 Biopsy of finger or toe nail 20526 Injection of

ENT 2017 Changes

By: Lois McGruder-Jarman, CPC Director of Coding & Compliance, MedCycle Solutions I’ve got great news.  There weren’t that many changes in Calendar Year 2017 to ENT Procedures.  That is a good thing – because many of us are creatures of habit! And in the past when there have been changes to CPT Codes, sometimes the wording was significantly different.  Having

Telehealth Implications in Mental Health: An Overview

TeleHealth

By: Lois McGruder-Jarman, CPC Director of Coding & Compliance, MedCycle Solutions   Many Mental Health professionals at this time are hesitant to enter this particular aspect of their scope of practice due to licensing concerns about treatment of patients across state lines, in addition to potential HIPAA concerns (hacking of emails and other data has become an increasing problem of

Did You Know? Changes in Moderate Sedation

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By: Lois McGruder-Jarman, CPC Director of Coding & Compliance, MedCycle Solutions   Effective January 1, 2017 Moderate Sedation is no longer included with surgery and may now be billed separately? The previous codes (99143-99150) used to describe moderate sedation have been replaced with SIX new codes: the first three pertain to same provider performs surgery AND moderate sedation, and last

Medicare Out Patient Observation Notice (MOON)

Medicare

By: Lois McGruder-Jarman, CPC Director of Coding & Compliance, MedCycle Solutions   MOON was developed to inform patients of their status when they are not inpatient of a hospital or critical access hospital (CAH).  This went into effect February 21, 2017 and is to be implemented no later than March 8, 2017. What is the purpose of MOON you might

Did You Know? Ophthalmology

Ophthalmology

By: Lois McGruder-Jarman, CPC Director of Coding & Compliance, MedCycle Solutions At the beginning of 2017, changes were made to Ophthalmology codes. The code for Provocative testing for glaucoma (92140) has been deleted for 2017. The fluorescein angiography codes (92235 & 92240) have been revised to indicate that they are applicable for “unilateral or bilateral.” A new code 92242 has

Calendar Year 2017 – Changes to PT & OT

Photo credit Matthias Zomer

By: Lois McGruder-Jarman, CPC Director of Coding & Compliance, MedCycle Solutions   Well we knew this moment would come sooner or later after all the commotion over icd-10 was over.  If you, like myself try to memorize codes as a starting reference point – DON’T!  The good news for those of us who aren’t too keen on changes is that

SNF Consolidated Billing – Medicare Part A Categories

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by: Lois McGruder-Jarman, CPC   For simplification of the process, we will deal with two scenarios.  They are: Covered Medicare Part A SNF Stay Medicare Part B Non-Covered SNF Stay Covered Medicare Part A SNF Stay In this scenario, we have a Medicare beneficiary who is covered through Part A of Medicare – meaning that their medical services, room and

6 Positive Impacts of Effective Revenue Cycle Management

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As healthcare delivery gets more complex, patient reimbursement decreases and patient demand increases, practices are forced to reevaluate their revenue cycle management process. Some people underestimate the importance of effective revenue cycle management. RCM is the lifeblood of your practice. It determines almost all key performance indicators and practice health. Along with the obvious indicators, here are six positive impacts

Medicare ACO Track 1 Model

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by: Lois McGruder-Jarman, CPC   CMS-559-F Final Rule Advanced Care Coordination through Episode Payment Models (Cardiac and Orthopedic Bundled Payment Models This was finalized December 20, 2016, to continue Medicare’s push towards payments that reward QUALITY over QUANTITY. It also creates a strong argument for hospitals to deliver better care at lower cost for their patients.  Three key components of

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