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Feb 28, 2023
Cannot Downcode 93355 to 93312
1. Question. Can 93312 be used for a TEE performed in connection with a TAVR (or other transcatheter or intracardiac or great vessel...
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,...
Jan 23, 2023
Overview of 2023 ASA RVG
The 2023 ASA RVG (Relative Value Guide) confirms that for 2023 there are no new anesthesia codes, no deleted anesthesia codes, no changed...
Dec 5, 2022
What's New in Pain for 2023
REIMBURSEMENT REDUCTIONS Conversion Factors. Non-Anesthesia: The CF for non-anesthesia services (i.e., chronic pain injections, E/M...
Dec 5, 2022
What's New in Anesthesia for 2023
REIMBURSEMENT REDUCTIONS. Conversion Factors. Anesthesia: The CF for anesthesia is decreasing from $21.5623 to $20.6097. Non-Anesthesia:...
Dec 2, 2022
HIPAA: Online Tracking Vendors
Yesterday, the OCR released a 13-page HIPAA bulletin warning about online tracking vendors that use patients’ PHI to track patient...
Oct 28, 2022
AMA Bundles U/S with Post-op Pain Blocks
1. AMA Bundles U/S. I have just received the 2023 CPT Code. As recommended by Medicare in its Proposed Rule, the AMA has bundled...
Sep 1, 2022
Billing for Teaching CRNAs
A client recently requested me to write its Medicare carrier, Novitas, the following question regarding teaching CRNAs. Question. Can a...
Aug 22, 2022
No Surprises Act Final Rule
1. New Final Rule. On August 19, 2022, DHHS released a Final Rule under the No Surprises Act (“NSA”), which is limited in scope since it...
Aug 8, 2022
UDT; Recent Audits
A disturbing trend is occurring in UDT (urine drug tests) audits. Based on recent OIG audits in which I am involved, auditors are...
Jul 24, 2022
PHE Extended
HHS has extended the Public Health Emergency for another 90 days (until October 13, 2022). Moreover, if HHS decides to terminate the PHE...
Jul 18, 2022
Proposal to Bundle U/S in 2023
1. Projected AMA Bundling. The 2023 Medicare Proposed Rule for the Physicians Fee Schedule states that the AMA is going to revise the...
Jun 24, 2022
Noridian's Nationwide Facet Audits
We have attended several educational telephone calls with Noridian Medicare regarding its nationwide facet audits. If you are audited by...
Apr 22, 2022
Central Line: Where Does It End?
This week one of my clients sent me an audit by UHC which denied the client’s central line placement. UHC’s auditors took the position...
Apr 18, 2022
CRNA Supervision in Non-Opt-Out States
1. Scope of This Article. The purpose of this article is to differentiate between the required federal level of CRNA supervision in the...
Apr 1, 2022
Recent HIPAA Cases
The Office of Civil Rights ("OCR") has published 4 recent enforcement actions for alleged HIPAA breaches, as follows: 1. Copies of...
Apr 1, 2022
OIG's Playbook for Facet Audits
Overview. Would you like to have the OIG's playbook on how it will audit your facet blocks and RF procedures? We have it. The OIG is...
Mar 28, 2022
CMS Memo on Amniotic Fluid and Placental Tissue
New Coverage Memorandum. On March 25, 2022, CMS issued a Memorandum (“TDL-220299”), revoking prior instructions, and providing new...
Feb 25, 2022
No Surprises Act: Court Disallows IDR Process
On February 23, 2022, a federal district court in Texas held that the IDR (Independent Dispute Resolution) process in the NSA (No...
Feb 7, 2022
Cell Phone Use in the OR
On January 27, 2022, a federal district court in Utah ruled that a vascular surgeon’s False Claims Act case against an anesthesia group...
Dec 6, 2021
Surprise Billing Act Forms
If you are wondering what verbiage to use for your Disclosure Notice and your Notice and Consent forms required under the Surprise...
Nov 7, 2021
Highlights of 2022 Medicare Physician's Fee Schedule Final Rule
The 2022 Medicare Physician’s Fee Schedule Final Rule was released last week, containing over 2,000 pages. Introduction. Here are some...
Nov 5, 2021
OIG New Opinion on Anesthesia Kickbacks for Pain Practices
1. New OIG Opinion. Today the OIG emailed me a formal Advisory Opinion (21-15) which I requested 2 ½ years ago regarding whether it is...
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