In a recent release of 2018 benchmarks regarding modifiers 76, 77 and 79, the data of payment vs denials is staggering. For instance, a total of 159 codes reported with 91 and 249 codes that were reported using modifier 77 all had a 100% denial rate. Compared to the 952 codes that were denied when…
As Risk Adjustment (RA) and Hierarchical Condition Category (HCC) coding continue to grow and become common practice it is important for not just coders, but also our clinicians to recognize its importance and the effect it has on reimbursement. Below is an example of a procedure and notes regarding coding and why our clinician must…
In the January 23rd edition of the MLN Connects, CMS announced the release of a Comparative Billing Report (CBR) on Shoulder Arthroscopies for Medicare part B claims. This information can be vital for Orthopedic practices during the audit process. Data will be compared based on other providers in your state as well as nationwide. However,…
The New Year always brings opportunities to grow and learn. While many find it difficult to be healthy in the workplace there are simple steps to take to achieve a healthier lifestyle. Below are six great tips on building healthy habits at work. Read the article below to find out 6 ways you can build…
Vaping and E-cigarette use by young adults has grown over the past few years. While many are ignoring the effects of using these products, the CDC and CMS have released addendums regarding these products after the World Health Organization confirmed the side effects of vapes and e-cigarettes. Read below for more on these important updates…
Last week, we briefly described the X modifier series and when to substitute these new modifiers. Below are a few scenarios from the NCCI policy manual you can refer to when using these modifiers.* The CCI bundle involving column 1 code 45385 (Flexible colonoscopy with removal of tumor[s], polyp[s], or lesion[s] by snare technique) and…
It has been several years since CMS released the X modifier series, are you using these correctly or not at all? In an end of year survey, published in Part B News, 78% of respondents said they had reported an X modifier in 2019. The creation of the X modifier series is to report with…
The new year is a time for change, and many look at it as a time of reform. So as you make those resolutions to get back to the gym just remember that as we all get older, our bodies take longer to heal. Happy 2020! X50.0XX- Overexertion from strenuous movement or load [lifting heavy…
Seasons Greetings! The holidays are a time filled with love and laughter as we spend time with the ones closest to us. So while you’re out at family get together’s or running to the shops for the last-minute gifts here are a few codes to watch out for. Read below for some of the important…
As we approach 2020, we are gearing up for the changes that are making headway the coming year. Below are some of the updates that have been released regarding E/M changes, the final rule, and the physician fee schedule. For more information read below. For more on the services RT Welter provides contact us at…