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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...
3 / 21 / 2024

March is Kidney Awareness Month!

Introduction March is Kidney Awareness Month, and Pinnacle wants to share updates regarding the new conversion from v24 to v28.  What better way to celebrate than to brush up...
3 / 19 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Part One – Procedure to Procedure Edits

By
Lori Carlin &
Angela Wood
In the introduction, we discussed the three (3) edit types that make up the National Correct Coding Initiative (“NCCI”). Probably the most familiar of those edits are the procedure...
3 / 14 / 2024

National Correct Coding Initiative (“NCCI”) Manual: The Ultimate Medicare Billing Toolkit

By
Lori Carlin &
Angela Wood
One of the best resources we frequently recommend to providers is the National Correct Coding Initiative (“NCCI”) policy manual. It is like using a crystal ball to peer into...
3 / 5 / 2024

PHC 1st Quarter 2024 Real Estate Newsletter

By
Mike Vandaveer
Healthcare Real Estate Transactions Jackson Health Confirms $90 Million Expansion. Jackson Health System has selected Skanska USA as the contractor to complete a $90 million renovation and expansion project that...
2 / 15 / 2024

2024 Final Rule Part Four: Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)

By
Alysia Delozier
The Centers for Medicare and Medicaid Services (CMS) included some changes related to RHCs and FQHCs in the 2024 Final Rule. As referenced in our second article, CMS will...
2 / 8 / 2024

2024 Final Rule Part Three: Caregiver Training Services

By
Angela Wood
Effective January 1, 2024, the Centers for Medicare and Medicaid Services (“CMS”) established an active payment status for CPT codes 96202 and 96203 (caregiver behavior management/modification training services) and...
2 / 1 / 2024

2024 Final Rule Part Two: Behavioral Health Services

By
Alysia Delozier
The 2024 Medicare Physician Fee Schedule Final Rule revealed some great advancements in behavioral health services and how CMS will allow them to be billed.  We will highlight some...
1 / 25 / 2024

2024 Final Rule Part One: Split (or Shared) Evaluation and Management (“E/M”) Visits

According to the Centers for Medicare and Medicaid Services (“CMS”), Medicare Physician Fee Schedule Final Rule: “Split (or shared) E/M visits refer to visits provided in part by physicians...
1 / 18 / 2024

2024 Final Rule Summary of Changes

By
Angela Wood
The 2024 Medicare Physician Fee Schedule Final Rule is packed with changes that will impact physician’s revenue. In this article, we provide an overview of some of those changes....