Let’s have a conversation about the data column on MDM. Specifically, what I’d like to address is imaging services. When a provider performs an x-ray while seeing a patient, and they are not going to bill a professional component of that test, how do we count that service? Is that service something we can count?…
September 29, 2023 | By Grant Huang, CPMA, CPC If you’ve never heard of principal care management (PCM) or chronic care management (CCM) services before, you’re not alone. Medicare introduced these new benefits for Part B beneficiaries in 2021 and 2022, respectively, but the agency’s own utilization data shows that adoption has been fairly…
June 9, 2023 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CDEO, CPB, CFPC, CRC, CPEDC, CEMA President, Knowledge Tree Billing, Inc. You may be thinking, “Really, Pam? Are we talking about modifier 25 again?!?” Yes! Considering the recent uproar caused by one payer’s plan to implement a policy requiring prepayment review of…
May 20, 2022 | By Toni Elhoms, CCS, CPC, CPMA, CRC I know I am not the only one who is completely appalled by the recent bombshell story on Cigna’s shady claims adjudication practices. ProPublica recently published a scathing article that pulls back the curtain on “PXDX” – a cost-containment strategy deployed by Cigna…
In the expansion category of the 2021 documentation guidelines, there’s some information that may be a little confusing that would like to review with you in Today’s Take. On page 23, under Initial Hospital Inpatient or Observation Care, under the New and Established Patient, there’s a paragraph that reads a little confusing: “If a consultation…