Q: If an anesthesiologist performs a presurgical or postsurgical block for pain control and it is performed in a holding area rather than in the operating room (OR), can we bill a separate facility (technical) fee for that? Or would this be bundled with OR services?Read More »
The Office of Inspector General (OIG) recently released its annual report on solutions to reduce fraud, waste, and abuse in HHS programs. In the OIG’s 2022 report, 16 of the top 25 unimplemented recommendations involve CMS, with three relating to Medicare Parts A and B.Read More »
Automation and similar technologies are increasingly prevalent in revenue integrity but understanding best practices and long-term implications is still a major challenge. Learn how one organization is tackling misconceptions to make breakthroughs in deploying automation.Read More »
CMS finalized a higher-than-proposed payment increase that was almost erased for most non-drug services to offset ending reduced reimbursement for 340B drugs, according to the...Read More »
CMS is moving ahead with major changes to evaluation and management (E/M) services, telehealth, coverage of dental services, and more in the 2023 Medicare Physician Fee Schedule (MPFS) final rule. The rule, released November 1, also includes updates to vaccine payments and quality and reporting...Read More »
It’s helpful to understand payer-specific contract terms and government billing requirements when developing work lists or work queues and reports. Analyzing data that comes from claim scrubber edits, return to provider edits, variances, and denials can provide insight into repetitive issues...Read More »
Q: We are a critical access hospital (CAH). We provide smoking cessation therapy (CPT codes 99406-99407) in our cardiac rehab department. The documentation is done and signed by a respiratory therapist (RT), and we are currently billing this as a professional charge (on a UB-04 with revenue code...Read More »
