2 / 25 / 2021
Establishing an effective corporate compliance program, then managing and maintaining the program, is a complex and often difficult proposition for the traditional health care provider or health system. When the...
2 / 9 / 2021
Change is frequently difficult; however, without it, progress is stifled. As part of the Medicare Physician Fee Schedule Final Rule, in 2019 The Centers for Medicare and Medicaid Services (“CMS”)...
1 / 27 / 2021
By Allison Carty, JD, MBA Director, Pinnacle Healthcare Consulting Medicare Physician Fee Schedule Changes – What Now? An Introduction… As many in healthcare have been tracking, the Centers for Medicare...
1 / 4 / 2021
Beginning January 1, 2021, the new Centers for Medicare and Medicaid Services (“CMS”) Evaluation and Management (“E/M”) guidelines will take effect for Office and Other Outpatient codes *99202-99205 and 99212-99215....
10 / 14 / 2020
The Centers for Medicare & Medicaid Services (CMS) planned E/M office-visit guidelines and pay rates are scheduled to go into effect January 1, 2021. Get ready for these changes with...
7 / 30 / 2020
Modifier CS is used for the full reimbursement of COVID-19 testing visits from Medicare and private insurers. For services performed on March 18, 2020 through the end of the Public Health Emergency...
10 / 2 / 2019
If you have questions regarding the difference between a screening and a diagnostic test and when to bill for them separately-You are not alone! Let’s start by going over...
9 / 3 / 2019
When reviewing surgeries in order to determine whether an assistant is billable, coders and their providers should always be aware of what is needed in terms of necessity and documentation....
2 / 18 / 2019
Documentation requirements for physician Evaluation & Management (“E/M”) visits have not been updated in 20 years. On November 1, 2018, CMS finalized bold proposals that address provider burnout and...
2 / 11 / 2019
In 2019, Office of Inspector General (“OIG”) added the review of critical care evaluation and management codes to their work plan for the Office of Audit Services. This review...
