News Alerts
This section provides the latest and essential industry updates as they become available.
MAR
1
Billing for Services when Medicare is Secondary
Don’t deny treatment, entry to a SNF or hospital, or services based on an open or closed Liability (L), No-Fault (NF) or Workers’ Compensation (WC) Medicare Secondary Payer (MSP) record on the beneficiary’s Medicare file or if a claim was inappropriately denied.
JAN
19
APMA-Successful with Initiative to Increase MUE for CPT 28300
The APMA has requested that the National Correct Coding Initiative (NCCI) increase the Medically Unlikely Edit (MUE) of CPT 28300 (Osteotomy, calcaneus) from one to two,
stating their argument; that this was necessary to account for the situation when a double calcaneal osteotomy is needed.JAN
14
Post-Op Global Period Changes From 90 to Zero Days for Common Digital Amputation Procedures
The global surgical package for CPT 28820 (amputation, toe: metatarsophalangeal joint) and CPT 28825 (amputation, toe: interphalangeal joint) includes all the necessary services normally furnished by a surgeon before, during and after a procedure.
DEC
30
Major Stimulus Bill Pumps Funds into Healthcare
A $1.4 trillion government spending bill and $900 billion COVID-19 relief package, signed into law Dec. 27, includes a slew of provisions directed toward the Department of Health and Human Services, but one in particular will put money back into the pockets of healthcare practitioners.
DEC
21
Physicians/Practitioners: Medical Records Play a Vital Role in Ordering and Providing DMEPOS to Your Patients
For any DMEPOS item to be covered by Medicare, the patient’s medical record must contain sufficient information about the patient’s medical condition to substantiate the necessity for the type of equipment or supply, quantity and/or frequency of use or replacement, if applicable.
JUN
1
UnitedHealthcare COVID-19 End Date and Billing Guidance
The following resources will help you quickly reference the effective dates for UnitedHealthcare’s temporary benefit, program and procedure changes related to COVID-19, as well as billing guidelines for services such as COVID-19 testing, treatment and telehealth.
FEB
18
CMS Audits and How They Affect
Podiatry-TPE Audits-DMETargeted Probe and Educate (TPE) is one process that a Medicare Administrative Contractor (MAC) can utilize when providers are selected by Medical Review. The TPE review process includes three rounds of a prepayment probe review with education.
FEB
3
EHR Vendor Practice Fusion to Pay $145 Million for Illegal Kickback Opioid Scheme
Practice Fusion Inc., of San Francisco, will pay $145 million to resolve criminal and civil investigation into a kickback scheme involving the developer’s EHR software, according to a news release from the U.S. Justice Department.