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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...
Feb 18
Recent Chronic Pain Audits
There have been several recent chronic pain audits our clients are undergoing. 1. Kyphoplasty and Vertebroplasty. Performant...
Nov 16, 2023
DHHS Enforcement Actions Involving Anesthesia and Chronic Pain
DHHS just released its Annual Report for the Health Care Fraud & Abuse Control Program, wherein it detailed the Government’s latest...
Oct 6, 2023
Rx Drugs Not Enough for 99214
Most pain physicians try to achieve billing 99214 (moderate medical decision making) by relying on the fact that they have prescribed...
Sep 3, 2023
UDT Cannot be Billed as Incident to
In a recent TPE (Targeted Probe and Educate) audit that we are defending, Palmetto GBA (one of the Medicare carriers) is taking the...
Jul 18, 2023
Medicare Temporary Bundling of UDT Codes
1. Medicare Bundling of Screens and Definitive Tests. Effective July 1, 2023, CMS implemented NCCI edits between Column One codes...
Mar 28, 2023
New SIJ Injection LCDs
Five of the seven Medicare Carriers around the country have adopted a multijurisdictional new LCD for SI Joint Injections (“SIJIs”). The...
Mar 15, 2023
STIMWAVE Former CEO Indicted
Many of you have inquired about using STIMWAVE (“SW”) stimulator products and whether Medicare would pay for them. The DOJ just issued a...
Feb 20, 2023
Prescribing Excessive Opioids
Over the past several years, multiple pain physicians have been found guilty of illegally prescribing opioids in violation of the...
Feb 2, 2023
AMA Issues New Coding Guidance on Planar Blocks
1. Types of Blocks Addressed. The AMA has issued new guidance regarding the billing of plane (a/k/a"planar") blocks, including PECS I,...
Feb 19, 2015
Search Warrant Regarding Urine Drug Screens
The FBI has alleged, in an affidavit filed in support of a Search Warrant of Carolina Liquid Chemistries, that it is a crime to knowingly...
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