Q: If a patient comes into an outpatient facility for a surgical procedure and the physician evaluates the patient before performing the procedure, can you append modifier -25 to the E/M service?
Healthcare providers are often confused about what a commercial or managed care payer would want in order to approve the claim. Much of this confusion comes from the timing of requirements to ensure reimbursement.
This week's note from the instructor digs into the details of the expanded Medicare Diabetes Prevention Program. The article is the first in a multi-part series covering all aspects of the initiative.
The Government Accountability Office (GAO) has urged CMS to renew prior authorization programs slated to expire. The GAO made its case for continuing the programs in a report released in April, arguing that the programs reduced spending by nearly $2 billion since 2012.
This week’s Medicare updates include corrections to the 2018 Quality Payment Program final rule, two OIG reviews on issues related to Round 2 of the Competitive Bidding Program, the quarterly update to Part B drug pricing files, and more!
