Medicare Issues Reminder on Submission of Duplicate Claims

The Centers for Medicare & Medicaid Services (CMS) has issued a reminder about submitting duplicate claims to Medicare in a recent issue of the Medicare Quarterly Provider Compliance Newsletter (pdf). As Medicare notes, submitting duplicate claims for the same service encounter is inappropriate. Medicare does not make payment for duplicate claims that a provider may […]

CMS Releases New Version of Ambulance Fee Schedule Fact Sheet

The Centers for Medicare & Medicaid Services has released the latest version of its Medicare Learning Network “Ambulance Fee Schedule” fact sheet.  This fact sheet is intended to provide education on the Ambulance Fee Schedule and ambulance billing. It includes information on the following: Medicare ambulance transport benefit; types of ambulance providers and suppliers to […]

Highlights of Policy and Payment Changes to the Medicare Physician Fee Schedule for 2015

The Centers for Medicare & Medicaid Services (CMS) recently issued its final rule that updates payment policies and rates for services furnished under the Medicare Physician Fee Schedule (PFS) in 2015. Here are some of the highlights of the policy and payment changes for services furnished under the PFS. Screening and diagnostic digital mammography. Until […]

Coding Guidance for Smoking Cessation Counseling

The American Psychiatric Association provides a two-page resource discussing procedure coding for smoking cessation counseling. There are a number of different procedure codes that can be used to describe services provided to encourage changes in behavior of individuals who use tobacco. The resource identifies the CPT and HCPCS codes that describe smoking/tobacco cessation counseling, as […]

#1 Physician Complaint About Payers: Claims Denials

In a new survey by Medscape, physicians identified denial of claims as the worst experience they have with insurance companies. According to the survey’s results, published in the “Insurer Ratings Report 2014,” claims denials were the most frequently as well as the most intensively described negative experience. Medscape also asked physicians to rate payers on […]

Free Orthopedic ICD-10 Resources

The Centers for Medicare & Medicaid Services, as part of its “Road to 10: The Small Physician Practice’s Route to ICD-10,” offers a series of valuable, free ICD-10 resources for orthopedic surgeons. These resources include the following: 1. Common orthopedics codes. An illustrative sample of high-impact diagnosis codes related to common conditions that you may […]

CMS Establishes New Physician Specialty Code for Interventional Cardiology

The Centers for Medicare & Medicaid Services has announced (pdf) the establishment of a new physician specialty code for interventional cardiology: C3. According to an American College of Cardiology report, C3 “allows CMS to distinguish an interventional cardiologist from a clinical cardiologist when billing for Medicare services.” Previously, no such mechanism existed. As a result, […]