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6 / 27 / 2024

Psychotherapy Documentation Guidelines

By
Lori Carlin &
Alysia Delozier
Before we discuss documentation guidelines, let’s define psychotherapy. Psychotherapy, also known as talk therapy, is a type of therapy during which the provider uses a series of techniques to...
6 / 25 / 2024

Three Medicare Preventive Services That Can Be Performed Via Telehealth

By
Lori Carlin &
Angela Wood
If you haven’t already, you should utilize the Medicare Preventive Services education tool from The Medicare Learning Network! Not only does it lay out all of Medicare’s preventive services...
6 / 13 / 2024

Telehealth Updates – CMS 2024 Final Rule

By
Lori Carlin &
Angela Wood
Since 2020, telehealth services have seen many changes, but there were some significant changes to telehealth in the Centers for Medicare and Medicaid Services (“CMS”) 2024 Physician Fee Schedule...
5 / 30 / 2024

Just When We Thought It Was Safe to Go Back in the Water: The Transforming Episode Accountability Model (TEAM) Has Been Released

By
Amy Crenshaw-Pritchett
Introduction On April 10, 2024, The Centers for Medicare and Medicaid Services (CMS) released the proposed Inpatient Prospective Payment System (IPPS) for Fiscal Year (FY) 2025. Within the release...
5 / 23 / 2024

Compliant Speaker Programs: How Life Sciences Companies Can Mitigate Risk

By
Ann Brandt
Pharmaceutical, medical device, and biotechnology companies (collectively life sciences companies or “LSCs”) utilize outside ‘experts’ (“Healthcare Professionals” and “Key Opinion Leaders”, collectively “HCPs/KOLs”) to provide a wide variety of...
4 / 25 / 2024

Revolutionizing Medicare with ACO Primary Care Flex Model: Enhancing Access and Equity

By
Kelly Conroy &
Zach Maher &
Daniela Yusufbekova
Every primary care physician (PCP) in the United States should be integrated into an accountable care model. The primary objective of accountable care models is to provide all participating...
4 / 23 / 2024

Visit Complexity Add-On Code G2211 FAQs

By
Lori Carlin &
Angela Wood &
Alysia Delozier
Recently, we have been getting questions about the new Healthcare Common Procedural Coding System (“HCPCS”) code G2211 (Visit complexity inherent to evaluation and management associated with medical care services...
4 / 17 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Bonus Article – Billing Bilateral Procedures

By
Lori Carlin &
Angela Wood
If you have questions about how to properly bill Medicare for bilateral procedures, the National Correct Coding Initiative (“NCCI”) policy manual has your answers. Starting on page 30 of...
4 / 3 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Part Three – Add-On Code Edits

By
Lori Carlin &
Angela Wood
In this series of articles on the National Correct Coding Initiative (“NCCI”) Policy Manual, we have discussed procedure to procedure (“PTP”) edits and medically unlikely edits (“MUE”), but were...
3 / 26 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Part Two – Medically Unlikely Edits

By
Lori Carlin &
Angela Wood
In part one we discussed procedure to procedure (“PTP”) edits. In this article we will discuss Medically Unlikely Edits (“MUEs”). The Centers for Medicare and Medicaid Services (“CMS”) defines...