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…
New developments from the Centers for Medicare & Medicaid Services (CMS) regarding policy changes were released earlier this month. The proposed changes will effect drug programs in 2023 to create more helpful options for Medicare Advantage and Part D consumers. Continue reading below to learn more about the notice. The Centers for Medicare & Medicaid…
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…
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…
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…
While it is said D.C. is slow to make progress on healthcare, individuals are stepping up with a plan noting that “The health of our nation is more important than any political party.” With changes and advancements in healthcare, the state of Colorado is implementing a new law that gives Colorado officials the authority necessary…
As difficult as it may be, embracing change is essential to growing as an individual, being a better employee and a better person than you were yesterday. Focusing on a positive perspective when faced with difficult challenges or changes can help us adapt when we are pushed out of our comfort zones. The following article…
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 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…
Colorado Governor, Jared Polis, has been in the news for his ‘roadmap’ to reduce healthcare costs. We now uncover the latest developments of a state-run health insurance option. This advancement is seen as a step toward universal healthcare, but only one part of his strategy for achieving universal coverage. Read the article below to learn…