Podiatry Billing Insights

However, a newly finalized Medicare payment policy could reduce reimbursement for certain same-day services beginning January 1, 2027.

In New York, routinely waiving patient responsibility can create a compliance issue. The legal issue comes from New York’s insurance-fraud laws and how DFS has applied those laws to patient cost-sharing.

A Guide to Skin Biopsy and Fine Needle Aspiration Codes October 1, 2018 marked the third mandated update to the ICD-10-CM and ICD-10-PCS classification systems. All providers, coders and billers as well as anyone who deals with medical insurance claims needs to be aware of these changes and how to interpret them. Numerous coding changes for 2019 have directly impacted podiatrists. In the past, CPT code 11100 was reported for a skin biopsy of the first lesion and 11101 for e

Hopefully by now you have all heard about the efforts that are being made to streamline E/M coding and documentation. The process providers need to go through to meet criteria when documenting their patient’s visits has been an unremitting chore. Instead of just making a note which discusses the patient’s issues and their treatment, the provider has the arduous responsibility of proving system or organ reviews, patient history and medical decision making. Keeping track of med

Medical practices are noticing an increase of patients paying cash for services and products. Some of the reasons we are seeing a shift...

Determining the difference between New/Initial and Established E+M Codes We have found that many physicians run into some confusion when coding and billing for evaluation and management (E+M) services, regarding when to code new/initial or established visits. The term “new” is used for office visits and “initial” for hospital care. Codes are based on if you see the patient in the office or in a hospital/nursing home. In the office: A new patient is one who HAS NOT received

Carri Garbus is certified and a proud member of MRMAA. The Medical Revenue Management Association of America (MRMAA) provides training,...

Many providers are having a difficult time with increased workloads, a result of the Affordable Care Act, ever-changing guidelines, prior...

The Centers for Medicare and Medicaid Services (CMS) on July 27 released its plan to reduce paperwork and improve patient care.1 What CMS is proposing is to combine the evaluation and management (E&M) codes - that are currently CPT codes 99202 through 99205 for new patients, and CPT codes 99212 through 99215 for established patients, to a single payment level for a new patient and a single payment level for an established payment. Podiatrists are being singled out from all ot

By April 2019 the Social Security Numbers on all Medicare cards will be removed as required by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Personal identity theft affects a large and growing number of seniors. People age 65 or older are increasingly the victims of this type of crime. Incidents among seniors increased to 2.6 million from 2.1 million between 2012 and 2014, according to the most current statistics from the Department of Justice. Identity th