ModeratorJulia

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ModeratorJulia
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  • Hello, Thanks for your question. From my reading of a few other MACs' guidance, the issue boils down to the fact that a locum isn't an option because the practice can't use the deceased provider's NPI/PTAN to report the locum's services. (Regard…
  • Thank you so much. This is the best explanation I've seen of why the doctor isn't paid for the add-on in facility.
  • Here's what I know so far: CCI improperly bundled moderate sedation into about 30 codes. Providers will be able to appeal those denials on or after April 1. https://www.acr.org/Advocacy/eNews/20170106-Issue/20170106-CMS-to-Correct-Errors-to-NCCI-Se…
  • Thanks Donna, I'm keeping a running file of weird problems with this code. Do you mind saying which MAC this is?
  • The way someone from the ASA explained to me is that the anesthesia provider should fully document the pre-op eval. That way IF the service is cancelled at the right time AND the anesthesia provider's documentation shows his work reached the level o…
  • Just a reminder that Part B News - host of this listserv - has already published several articles about MIPS. Subscribers may submit questions directly to the editorial team. Thanks!
  • Hi and thanks for your question. Are you wanting a list of codes that you'll use to report measures? This might be a place to start: https://www.cms.gov/apps/ama/license.asp?file=/PQRS/downloads/PQRS_2016_Measure_List_01072016.xlsx To your earlie…
  • Hi, Here is some information on how CMS defines eligible providers for 2016. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2016_PQRS_List_of_EPs.pdf I know that in the proposed rule for next year…
  • That's a good question. The descriptors for drug screen G-codes G0480-G0483 state "per day," so I don't know why private payers would allow more than one unit of service for one patient on the same day.
  • As others have said, it will depend. For example, Noridian says no: Q8. When submitting an ICD-10 code on a claim, is it appropriate to include the decimal point? A8. No. Do not include a decimal point when billing an ICD-10 code.