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UHC No Longer Reimbursing for Consult Codes

Effective for claims with dates of service on or after Oct. 1, 2017, UnitedHealthcare will reimburse the appropriate evaluation and management (E/M) procedure code which describes the office visit, hospital care, nursing facility care, home service or domiciliary/rest home care reported in lieu of a consultation services procedure code. This notification will be the first…


Code Spotlight — M48.062 Spinal Stenosis Lumbar Region with Neurogenic Claudication

RT Welter & Associates is excited to present our monthly Code Spotlight! Each month, RT Welter & Associates will spotlight a unique CPT or ICD-10 code to profile and discuss practice applications of the code, as well as pertinent guideline reminders. M48.062 – Spinal Stenosis, lumbar region, with neurogenic claudication The list of ICD-10 code updates is…


CMS Innovation Center

As a result of the many provisions of the Affordable Care Act (ACA), the CMS Innovation Center (CMMI) was created to promote quality healthcare, stronger health outcomes, and encourage fiscal responsibility. CMMI acts as the facilitator for designing the most efficient payment methodology for reimbursing healthcare providers based on value rather than volume. CMMI also…


Industry Hot Buttons — Biomechanical Device Coding

Biomechanical Device Coding: Spine surgery has been one of the specialties hardest hit by recent CPT code bundling, NCCI edit updates, code revisions and additions, and RVU decreases. Most recently, biomechanical device coding changes were implemented, which impacts many spine surgery practice’s bottom lines. This change essentially states that all anterior instrumentation is now bundled…