2021 CPT® E/M Guidelines for Office/Outpatient History and Exam The Guidelines for Office or Other Outpatient E/M Services will help you understand the revised E/M codes and how to apply them in 2021. The History and/or Examination portion of these E/M guidelines explains that office and other outpatient E/M services include “a medically appropriate history and/or […]
Read MoreHealthcare professionals across a wide range of specialties commonly report E/M codes on insurance claims to request reimbursement for services. The lengthy process required for accurate E/M coding and documentation has caused a lot of confusion and frustration for medical coders and providers over the years. That is one reason why the American Medical Association […]
Read MoreJust when you thought you got your head semi-wrapped around Medicare telemedicine rules, they go and throw it out the window! On March 30, CMS issued an Interim Final Rule and released new guidance on how to code and bill for rapidly evolving telehealth services. Before you file another claim, here are the three sweeping changes you must implement […]
Read MoreThe 2020 update to the Medicare Physician Fee Schedule includes six new codes that are part of the 2020 Current Procedural Terminology (CPT®) code set will help physicians and others report a range of digital health services including electronic visits through secure patient portal messages. The new codes are spurred by digital health tools that are growing […]
Read MoreEffective January 1, 2020, all claims submitted to Medicare must be billed with the new Medicare Beneficiary Identifier (MBI) in place of the Health Insurance Claim number (HICN). The new year is almost here, and the Novitas EDI Department wants to make sure you are ready! As of January 1, 2020, any claim files submitted without the […]
Read Morehttps://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE18006.pdf Starting January 1, 2020, even for services provided before this date, you must use MBIs. With a few exceptions, Medicare will reject claims you submit with Health Insurance Claim Numbers (HICNs.) Medicare will reject all eligibility transactions you submit with HICNs.
Read MoreMLN Connects for August 8, 2019 Protect your patients’ identities by using the Medicare Beneficiary Identifier (MBI) now. Starting January 1, 2020, you must use the Medicare Beneficiary Identifier (MBI). We will reject claims you submit with the Health Insurance Claim Number (HICN), with a few exceptions, and reject all eligibility transactions. Fee-for-Service claim exceptions: […]
Read MoreMedicare wants their money back. At least that’s what their “60-day rule” regulations say, and the increase in lawsuits they are filing against practices just like yours to get it. Lack of compliance with these regulations can lead to you being fined up to $11,000 for each improper payment you received and didn’t return (going […]
Read MoreCMS requires Medicare providers and suppliers to revalidate their enrollment every 3 or 5 years. Failure to revalidate on a timely basis can result in a deactivation of your Medicare enrollment records. This means, until the revalidation is submitted and approved, you may not be eligible to receive reimbursement from Medicare. The good news is […]
Read MoreYour chances of getting audited for your non-physician practitioner (NPP) claims continues to climb – especially your incident-to claims. CMS is just waiting for you to slip up. I found these NPP/incident-to related cases on the Office of the Attorney General (OIG) website. I was floored by the size of the penalties. Pretty eye-opening stuff…• […]
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