Medical Decision Making: Drug Therapy Requiring Intensive Monitoring for Toxicity

There are often questions and confusion on what is included and acceptable when choosing “Drug therapy requiring intensive monitoring for toxicity” in the Medical Decision-Making Risk category for Evaluation and Management coding. This article reviews the definition and guidelines as provided by CMS and their Medicare Administrative Contractors (MACs). Risk: High MDM – Drug therapy…

Routine Medical Supplies Coverage and Guidelines

Routine Medical Supplies Coverage and Guidelines

By: Sheila Haynes – Coding and Compliance Manager Correct coding and code definitions apply in all circumstances and to all provider types. Whenever a code is billed which includes another service or supply, whether by code definition or by coding guidelines, the included service or supply is not eligible for separate reimbursement. Supplies For Professional…

Setting the Stage for Success

Medical billers, coders, compliance officers, practice managers, and other healthcare business professionals joined AAPC on Dec. 9 for the first day of ELEVATE. The two-day leadership conference is dedicated to career development and helping healthcare business professionals learn what they can do to enhance their skill sets and advance their careers. The virtual event features…

Study Ranks Colorado 11th for Health Care

The residents of Colorado are working hard to improve our healthcare system throughout the state. A recent study ranked Colorado number 11 in the US based on several different variables, however, health care costs in Colorado were ranked 47. Read the article below recapping the results from the survey and other placement factors. A new…

Colorado’s Health Exchange Premiums Expected to Drop 18% – if Feds Approve Reinsurance

Health insurance premiums have been an ongoing topic of discussion for Colorado government leaders, medical professionals, insurance companies and patients. With continuous changes throughout the industry, the latest development includes the drop of health exchange premiums. Read the article below for more information recently released and the expectations to come. Western Slope families could save…

Changes to Timely Filing Requirements

Changes to timely filing requirements for commercial and Medicare Advantage plans for all claims submitted to plan on or after October 1, 2019 Anthem Blue Cross and Blue Shield and HMO Colorado (hereinafter collectively referred to as Anthem) continues to look for ways to improve our processes and align with industry standards. Timely receipt of medical…