A small provision of the 2021 Consolidated Appropriations Act paves the way for Medicare patients to eventually pay no coinsurance for colorectal cancer screening tests when they become diagnostic. CMS finalized how that guideline will be enacted in the 2022 Medicare Physician Fee Schedule. READ MORE
When claims are denied by Medicare, providers have the right to appeal the decision. In fact, providers can appeal a decision up to five times–all the way to a judicial review in U.S. District Court–if they disagree with the rulings. But not all denials merit an appeal, and when they do, each level of appeal is different and must be sent to a different contractor. Wondering if an appeal is your next step? Here’s how to know when you should appeal and at what level and where to send it. READ MORE
Emergency departments serve on the frontline of the fight against drug overdoses and opioid use disorder. While there have been several barriers to providing and billing for medication assisted treatment in the ED, many of those barriers have been reduced or eliminated. When emergency physicians do administer and/or prescribe MAT, here’s what they should document and code for their services. READ MORE
The Medicare Place of Service Workgroup recently revised the telehealth place of service codes to reflect the need for greater specificity in the industry. While Medicare itself has not identified a use for the update within their own billing guidelines, they’ve made changes because “the healthcare industry has a greater need for specificity than Medicare” and “this eases coordination of benefits and gives other payers the setting information they need.” READ MORE
