3 / 28 / 2024
Introduction & Background Following the enactment of the Patient Protection and Affordable Care Act (PPACA) in March 2010, the healthcare industry has experienced a major shift in its reimbursement...
3 / 26 / 2024
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
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
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
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
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
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
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
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
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...