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.
Predicting CMS policies can be a foolhardy exercise, especially with a relatively new administration and frequent turnover at the highest levels of HHS over the last year. But it’s safe to say drug payment policy has been and will continue to be a focus of the current regime.
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.
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!
