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 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 17, 2017
Medicare Web

Q: Does a physician physically need to inject a sedating agent to justify the use of a moderate sedation code?

November 16, 2017
Medicare Web

Q: It is my understanding that we can make PHI disclosures using our EHR for payment/treatment/healthcare operations without a consent and that we do not need to track these requests for an accounting of disclosures. Has this changed?

November 15, 2017
Medicare Web

The acute kidney injury (AKI) dialysis payment rate is $232.37 for CY 2018, as updated by CMS in the 2018 End-Stage Renal Disease Prospective Payment System (ESRD PPS)

November 15, 2017
Medicare Web

Q: What should my staff focus on when conducting case management patient assessments?

November 14, 2017
Medicare Web

CMS announced partial settlement agreements and instructions for Medicare Administrative Contractors in relation to several 2-midnight rule cases.

November 13, 2017
Medicare Web

A Comprehensive Error Rate Testing (CERT) study showed insufficient documentation causes most improper payments for arthroscopic rotator cuff repairs, according to the October 2017 Medicare Quarterly Compliance Newsletter.

November 10, 2017
Medicare Web

Q:  When it comes to conditions not related to hypertension, is it sufficient to attribute the diagnosis to another etiology or does the provider need to specifically document that the congestive heart failure (CHF) is not due to hypertension?

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