2024

Aug 13

Rx Drug Management for 99214

Listing the Patient’s Medications. Many physicians think that if they document in their progress notes a list of the medications the...

Apr 23

Audits of Levels and Sides of Injections

1. Procedure Title vs Procedure Detail. In a recent audit of one of our clients, Medicaid auditors disallowed epidural and facet...

Apr 23

New Trigger Point LCDs

Five of the seven Medicare Carriers have just adopted a new multi-jurisdictional LCD for Trigger Point Injections (“TPIs”). The new LCDs...

Apr 19

Incident to: Medication Changes

Query. If a midlevel practitioner (NP/PA) adjusts medication on a follow-up visit, can that visit be billed incident to, in the name of...

Apr 11

Aetna Stops Paying for Physical Status

One of our clients just forwarded a publication from Aetna dated April 8, 2024, providing a required 90-day notice that effective July...

Apr 8

Depo-Medrol Coding Changes

For pain practices still using and coding for the steroid Depo-Medrol, CMS has changed the coding effective April 1, 2024. CMS has...

Mar 21

OCR Requires BAAs with Tracking Vendors

1. Overview. The OCR is clarifying the obligations regarding online tracking technologies used in your websites and mobile apps....

Mar 13

Billing New Medicare Add-on Code G2211

1. Overview. I have received many questions about the new Medicare code G2211 which is an add-on code that can be billed to Medicare...

Feb 23

HIPAA Updates

On February 14, 2024, the Office of Civil Rights (“OCR”), which investigates HIPAA and issues fines and penalties, released a report to...

Feb 18

Recent Chronic Pain Audits

There have been several recent chronic pain audits our clients are undergoing. 1. Kyphoplasty and Vertebroplasty. Performant...

Feb 18

Denials of Post-op Pain Blocks

1. Post-op Pain Block Denials. United Healthcare (“UHC”) has started denying post-op pain blocks (“POP Blocks”) if there is no...

Jan 24

E&M Levels: Medicare Data

Many of you have periodically requested information as to the Medicare data on how your peers are billing 99202-99205 and 99211-99215 now...