News & Analysis

November 27, 2017
Medicare Web

What are some examples of extenuating circumstances that could be modified with an -XU modifier (unusual nonoverlapping service) if none of the other -X modifiers are applicable?

November 22, 2017
Medicare Web

Rush University Medical Center in Chicago did not comply with Medicare billing requirements for 57 inpatient and outpatient claims reviewed by the OIG, according to the OIG’s November report. This resulted in unlawful reimbursement for calendar years 2014 and 2015 with the medical center receiving $814,150 in overpayments, says the report.

November 22, 2017
Medicare Insider

This week’s Medicare updates include an advisory opinion on using network hospitals for inpatient stays; annual updates to HCPCS codes used for home health consolidated billing and the therapy code list; the removal of hyperbaric oxygen therapy (topical application of oxygen) from an NCD; and more! 

November 20, 2017
Medicare Web

I have heard of a modifier -GD in relation to the Medically Unlikely Edits. What is the definition of this modifier and how is it used?

November 17, 2017
Medicare Web

A CMS representative solicited input from audience members on potential revisions to E/M documentation guidelines at the AMA’s 2018 CPT Symposium in Chicago this week, continuing the agency’s outreach on E/M reform that began with this year’s Medicare Physician Fee Schedule proposed rule. 

November 16, 2017
Medicare Insider

This week’s note is the third in a series of articles examining coding, billing, and payment rules for rural health clinics.

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