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Posting Date: 10/27/2022
Documentation Required for Home Visits
Documentation Required for Home Visits CPT Codes 99341‒99350 As of 1/1/2019, CMS no longer requires providers to differentiate medical necessity for a home visit versus an office or outpatient visit. Providers no longer need to document [...]
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Posting Date: 10/27/2022
Referring, Monitoring and Certifying Home Health Services
Referring, Monitoring and Certifying Home Health Services Table of Contents Referring, Monitoring and Certifying Home Health Services Homebound Status Need for Skilled Services Under the Care of a Physician or Allowed Practitioner Plan [...]
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Posting Date: 10/27/2022
Scribing Medical Record Documentation
Scribing Medical Record Documentation National Government Services recognizes an increasing trend in providers’ use of scribes as assistants in medical record documentation. In these situations, a provider utilizes the services of staff to [...]
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Posting Date: 10/27/2022
Submit Medical Record Documentation Electronically
Submit Medical Record Documentation Electronically Table of Contents Submit Medical Record Documentation Electronically What do you need to get started? What are the Attachment Transactions? Who can use the Attachment Transactions? [...]
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Posting Date: 10/10/2022
Anesthesia for Pain Management Procedures
Anesthesia for Pain Management Procedures The use of moderate or deep sedation, general anesthesia, and MAC is rarely indicated for pain management procedures and is not considered reasonable and necessary. The ASA provides guidelines for [...]
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Posting Date: 11/29/2021
Remittance Advice
Remittance Advice Table of Contents General Information Electronic Remittance Advice Remittance Message Codes Standard Paper Remittance General Information Once Medicare has processed a claim, the provider will receive a notice [...]
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Posting Date: 10/19/2022
Outpatient Services for Registered Inpatients
Outpatient Services for Registered Inpatients There are occasional circumstances in which a registered inpatient may require a service that is not available at the inpatient facility. These inpatient facilities include acute-care hospitals [...]
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Posting Date: 10/19/2022
Allergen Immunotherapy Preparation (95144-95165)
Allergen Immunotherapy Preparation (95144‑95165) National Government Services will allow the preparation and provision of antigen for allergen immunotherapy, codes 95144 through 95165 when performed incident to by auxiliary personnel. However, [...]
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Posting Date: 10/19/2022
CPT Code 15830: Excision, Excess Skin and Subcutaneous Tissue; Abdomen, Infraumbilical Panniculectomy
CPT Code 15830: Excision, Excess Skin and Subcutaneous Tissue; Abdomen, Infraumbilical Panniculectomy CMS created the Medicare Physician Fee Schedule Look-up Tool for MACs to follow when processing claims. CMS listed CPT code 15830 as a [...]
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Posting Date: 10/19/2022
Fee-For-Time Compensation Arrangement and Reciprocal Billing Job Aid
Fee-For-Time Compensation Arrangement and Reciprocal Billing Job Aid Table of Contents Fee-For-Time Compensation Arrangement and Reciprocal Billing Job Aid Fee-For-Time Compensation Arrangements Reciprocal Billing Arrangements Related [...]
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Posting Date: 10/19/2022
Answers to Common Fee-for-Time Compensation Arrangements Questions
Answers to Common Fee-for-Time Compensation Arrangements Questions Does a fee-for-time compensation arrangement physician need to enroll with Medicare prior to acting as a physician? Answer: Currently, a fee-for-time compensation [...]
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Posting Date: 10/19/2022
Nonphysician Practitioners Billing for Surgical Procedures
Nonphysician Practitioners Billing for Surgical Procedures Several providers have asked about the Medicare guidance for NPPs include billing for surgical procedures. For the purpose of this education, NPPs include NPs, PA, and CNSs. State law [...]
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Posting Date: 10/20/2022
Professional Services During a Patient Hospice Election
Professional Services During a Patient Hospice Election Table of Contents Article Overview Hospice Election Medicare Payment During Hospice Election Determining the Correct Entity to Bill Separately Payable Part B Services Hospice and [...]
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Posting Date: 10/19/2022
Proper Billing for Finger and Toe Procedures
Proper Billing for Finger and Toe Procedures When billing for procedures that are performed on the fingers and/or toes, it’s essential to append the appropriate anatomical modifier for the service rendered. This allows the patient history to [...]
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Posting Date: 10/19/2022
Proper Submission of Fee-For-Time Compensation Arrangements and Reciprocal Billing Arrangements
Proper Submission of Fee-For-Time Compensation Arrangements and Reciprocal Billing Arrangements Table of Contents Proper Submission of Fee-For-Time Compensation Arrangements and Reciprocal Billing Arrangements Fee-For-Time Compensation [...]
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Posting Date: 09/08/2021
Proper Use of Taxonomy Codes
Proper Use of Taxonomy Codes A taxonomy code is a unique ten-character code that designates your classification and specialization and enables providers to identify their specialty at the claim level. CMS developed a crosswalk of [...]
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Posting Date: 10/19/2022
Common Reciprocal Billing Questions and Answers
Common Reciprocal Billing Questions and Answers If a practice, the same specialty as ours, wants us to take calls for them for two weeks, can we bill under their number as a reciprocal billing arrangement? Answer: No. In a reciprocal [...]
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Posting Date: 10/19/2022
Reminder for Avoiding Claim Denials for Positron Emission Tomography Scans
Reminder for Avoiding Claim Denials for Positron Emission Tomography Scans Background It has been noted that a high volume of PET scan claims falling between the CPT code range 78811–78816 are being denied upon original claim submission due [...]
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Posting Date: 10/19/2022
Unlisted and Not Otherwise Classified Procedure Codes
Unlisted and Not Otherwise Classified Procedure Codes Table of Contents Unlisted and Not Otherwise Classified Procedure Codes Proper Billing for NOC Procedures Electronic Claims Paper Claims The following tips will help you bill [...]
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Posting Date: 03/17/2023
Fiscal Year/Calendar Year Claim Split
Fiscal Year/Calendar Year Claim Split Part A/B Type of Bill Fiscal Year Split Calendar Year Splint Part A – 11X, 21X prospective payment system (PPS*) No No Part A – 11X, 18X, 21X, non-PPS Yes [...]
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