November 29, 2024 | By Terry A. Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM, PACS Telehealth 2025: The Final Rule CMS issued the calendar year (CY) 2025 Medicare Physician Fee Schedule (MPFS) final rule on Nov. 1, 2024, publishing guidance that will have providers and coders scratching…
November 22, 2024 | By Jordan Johnson, MSHA Coding for oncology services is an intricate task, requiring attention to detail, a deep understanding of clinical workflows, and the ability to navigate multiple systems and payer requirements. In radiation oncology, services often span multiple months, with a patient’s treatment involving 30-50 Current Procedural Terminology (CPT)…
November 15, 2024 | By Scott Kraft, CPMA, CPC When I audit services performed in an infusion center, I’m addressing two key questions. First, were all of the patient’s infusion, injection, and/or hydration services documented appropriately for what is being billed? Second, if evaluation and management services were performed, were they medically necessary and…
Insurance Discrimination – Against the Provider Author: Jeana M. Singleton, Esq. When the concept of “insurance discrimination” rears its ugly head, we often think of it in the context of when an insurance company treats some people differently than others based on protected classes, such as race, national origin, sex, or religion. Sometimes, this type…