The proposed merger of Aetna Inc. and Humana Inc. was blocked by a United States Federal Judge earlier this week. Read more about this in the article below. A U.S. judge blocked on Monday health insurer Aetna Inc’s proposed $34 billion acquisition of smaller peer Humana Inc, raising the stakes for rival Anthem Inc as…
The Affordable Care Act (Obama Care) looks to be the first target of a Republican dominated House, Senate and President! Much in the ACA is entangled in the current tax code. It will not be as simple as defunding it. The employer and individual mandates, the premium tax credit, the (so called) Cadillac Tax, the…
Tom Price’s Vision – Commercial & Individual Encourage Private Exchanges for purchase of individualized products across state lines Create federal Grants for States to create high-risk pools Eliminate individual Mandate Comprehensive Medical Liability Reform allowing conformity to clinical guidelines to serve as an affirmative defense to liability Claims Transparency from insurers to employers and individuals…
Written By: Toni Elhoms, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer Director of Coding/Compliance Consulting Services It’s that time of the year again! The new 2017 CPT code changes take effect January 1st. Understanding the myriad of upcoming changes is crucial to obtaining the proper reimbursement for your services! The changes for 2017 address a number of…
Moderate sedation services have historically always been bundled into the majority of all applicable CPT procedures. More than 400 codes that were previously defined as including moderate sedation have been deleted from Appendix G. In addition to six new CPT codes and one new endoscopy-specific HCPCS code, CMS intends to create a “uniform methodology for…
Effective Jan. 1st, CMS will begin paying for complex CCM services (99487-99489) in addition to normal CCM (99490). These CPT codes have been around for a while, but CMS has always refused to reimburse for them. Keep in mind, to get paid, you must be able to properly note all the moving parts of this…
Several new codes will replace long time spinal biomechanical device code 22851. The new codes are more specific regarding the type and location of the biomechanical devices. 22853 – Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in…
Influenza codes received a makeover with this year’s CPT update. The codes are no longer classified based on age. The descriptions of these codes now reflect dosage amounts. Codes now state “becomes 0.25 mL dosage” in place of “when administered to children 6-35 months of age” and “becomes 0.5 mL dosage” in place of “when…
Physical and occupational therapy codes received a major overhaul with this year’s CPT update. Codes have been expanded to take into account the overall evaluation complexity. The new codes incorporate a tiered level of complexity for physical and occupational therapy as well as athletic training evaluations. These new codes also require a substantial increase in…
There are 8 new CPT codes to reflect epidural spinal injections. These new codes are classified by both anatomy and whether imaging guidance was used and replace codes 62310 – 62319. 62320 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement,…