Medicare billing for Cataract Post-Op Co-Management

Co-management compliance is tracking down by the U.S. Department of Health and Human Services OIG (Office of Inspector General). You should manage the patient’s transfer of care correctly as well as it must be medically acceptable (determination is made by the surgeon and the patient). Transfer of care is defined as a transfer of responsibility […]


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Medicare Coverage for Wound Care

Medicare covers wound care for all beneficiaries, irrespective that it is carried out in an inpatient or outpatient setting. It can be expensive for patients. Few people may suffer from post-surgical lesions. Other patients may suffer from chronic fungal or viral wounds. Due to the prevalence of wounds with age, it’s simple to understand why […]


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Adult Elective Surgery and Procedures Recommendations during COVID-19

To aggressively address COVID-19, CMS recognizes that the conservation of critical resources such as ventilators and Personal Protective Equipment (PPE) is essential, as well as limiting exposure of patients and staff to the SARS-CoV-2 virus. The following recommendations are guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures. […]


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Medicare Fee-for-Service (FFS) Billing for COVID-19 Specimen Collection

As part of the Public Health Emergency (PHE) for the COVID-19 pandemic and in an effort to be as expansive as possible within the current authorities to have diagnostic testing available to Medicare beneficiaries who need it, in the interim final rule with comment period, CMS is changing the Medicare Fee-for-Service (FFS) Billing rules during […]


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Modifier -25 for Minor Retina Surgeries

The growth of intravitreal drug therapy for the treatment of retinal diseases over the past decade has been unprecedented. The number of intravitreal injections performed annually in the United States rose from less than 3000 in 1999 to more than 1 million in 2008, and it is estimated that more than 7 million intravitreal injections […]


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FAQs on Medicare Billing for Physicians in COVID-19 Pandemic

CMS is revising certain Medicare regulations to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in the Medicare program during the public health emergency (PHE) resulting from the COVID-19 pandemic. To that end, the IFC makes temporary changes to certain policies that will affect Medicare billing […]


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Newly Added Lab Specimen Collection HCPCS Codes COVID-19

CMS announced the creation of new COVID-19 lab specimen collection HCPCS codes G2023 and G2024 through their COVID-19 Interim Final Rule effective on and after March 01st, 2020. The rule specifies that these codes are only chargeable by independent laboratories and only in instances where trained personnel from the lab travel to collect the specimens […]


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Tracking Key Metrics for Laboratories and Diagnostic Providers

Tracking key metrics like clean claim and write-off rates is key to laboratories and diagnostic providers maximizing revenue. Submitting clean claims is one of the most important ways that a diagnostic organization can ensure payment in a timely manner from both private and government insurance payers. Receiving the maximum reimbursement the first time a claim […]


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Newly Added CPT Codes for COVID-19 Antibody Tests

The American Medical Association (AMA) on April 10, 2020, announced updates to Current Procedural Terminology (CPT®) that include two CPT Codes for COVID-19 Antibody Tests, intended to report when patients receive blood tests that detect COVID-19 antibodies. The updates were approved during a special meeting of the CPT Editorial Panel, the independent body convened by […]


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