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Dec 29, 2019
E/M Overhaul for 2021
1. Overview. Determining the level of 99201-99215 will be completely overhauled by both the AMA and CMS effective 1/1/2021 (not 2020). ...
Dec 29, 2019
What's New for Chronic Pain in 2020
This Article is designed to highlight the primary coding and billing changes affecting chronic pain in 2020. 1. CPT Code Changes. I...
Dec 29, 2019
What's New for Anesthesia in 2020
The following is a synopsis of the material billing, coding, and documentation changes affecting anesthesia in 2020. 1. Reimbursement. ...
Sep 6, 2019
Primer for Ordering Back Braces
Back braces have been targeted for the past 5 years by Medicare. We have defended several audits denying back braces for very technical...
Aug 4, 2019
New False Claims Act Case Involving UDT
On July 22, 2019, the U.S. DOJ intervened in a False Claims Act case against a Tennessee pain group and its owners, and filed a 104-page...
May 20, 2019
New Medicare Part D Opioid Policies for 2019
CMS has finalized new policies for Medicare Part D plans to follow beginning January 1, 2019. These changes are in response to the opioid...
Feb 6, 2019
Medicare Credentialing: Authorized Official vs Delegated Official
Chapter 15 of the Medicare Program Integrity Manual provides specific instructions as to who can sign initial Medicare credentialing...
Jan 31, 2019
New 855I Enrollment Form
Medicare has a new 855I Enrollment Application form. The 855I is for credentialing new physicians and NPPs (non-physician practitioners)...
Jan 29, 2019
New DOS Rules
On January 24, 2019, CMS released an update of its Date of Service (“DOS”) rules, i.e., when to bill services such as radiology, labs,...
Jan 19, 2019
How to Code an Erector Spinae Block
The AMA recently clarified in its December 2018 issue of the CPT Assistant whether an erector spinae block for post-op pain can be billed...
Jan 19, 2019
Does Modifier 50 Apply to TPIs?
The AMA recently clarified in its December 2018 issue of the CPT Assistant , whether a trigger point injection performed bilaterally can...
Jan 19, 2019
Injection of the Sciatic Notch
In the December 2018 issue of the CPT Assistant, the AMA issued instructions on how to bill for injection of steriod into the sciatic...
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