Medical Billing Forum
General Category => New! => : best biller December 02, 2012, 11:16:28 PM
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Is there any upcoming news for year 2013 which billers and doctors are suppose to know?
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Right now I would say the changes in the mental health codes is the biggest change coming up.
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Thanks so much,
Is there anything coming up for internal medicine?
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Google on: cms + "coding changes" (copy and paste if you wish)
That search provides quite a few links, both general and for specialties. Here are three of the general links.
http://www.acpinternist.org/archives/2012/11/coding.htm
http://www.hcpro.com/HIM-283402-3288/2013-IPPS-Final-Rule-Coding-HAC-CCMCC-and-MSDRG-changes.html
http://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/index.html
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Medicare Reimbursements Not Changing in 2013
Good news for doctors’ offices. The 26.5% cut in Medicare reimbursements to take effect January 1, 2013 has been averted as both the Senate and House voted to pass the “Fiscal Cliff” bill delaying Medicare cuts and adjustments to payments.
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Thanks...
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Too bad that's changed. 2% cuts go into effect April 1
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Ditto to Linda. All do due to the automatic spending cuts that were triggered a week ago.
http://money.cnn.com/2013/03/02/smallbusiness/medicare-doctors-spending-cuts/ (http://money.cnn.com/2013/03/02/smallbusiness/medicare-doctors-spending-cuts/)
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That's just reality.. you want to get into this business you need to prepare for all the QUICK changes and paces this industry takes.. it can sometimes be so tiring.
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Most recent news is 2% cut due to Sequester
http://medbill.net/2013/03/competitive-bid-rates-reduced-by-2/ (http://medbill.net/2013/03/competitive-bid-rates-reduced-by-2/)
and PECOS edits.
http://medbill.net/2013/03/are-you-prepared-for-the-may-1st-pecos-edits/ (http://medbill.net/2013/03/are-you-prepared-for-the-may-1st-pecos-edits/)
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Some More News....
CMS just released some more information on ICD-10. They released an email update. You can find the original release and links to thier resources below:
http://medbill.net/2013/03/icd-10-deadline-confirmed-by-cms-administrator/ (http://medbill.net/2013/03/icd-10-deadline-confirmed-by-cms-administrator/)
Also.. for DME Billers out there, VADMEC restarted their 'we the people' petition on WhiteHouse.gov to do away with the competitive bid and transition to a proposed Market Pricing Program. They need some signatures to get this noticed. They could use our help.
http://medbill.net/2013/03/vadmec-asks-you-to-help-promote-the-market-pricing-program/ (http://medbill.net/2013/03/vadmec-asks-you-to-help-promote-the-market-pricing-program/)
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For those of you Billing for North Carolina Medicaid it looks like they are trying to move towards Managed Care Plans for Medicaid
http://medbill.net/2013/04/nc-governor-wants-medicaid-patients-in-managed-care-plans/ (http://medbill.net/2013/04/nc-governor-wants-medicaid-patients-in-managed-care-plans/)
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Medicaid Managed care plans are not new in a lot of areas. They have been doing it a while and I think you will see MORE states doing it with Medicaid Expansion. What I wonder on a persona level is why don't they create different tiered plans for Medicaid by income level. I see nothing wrong with Medicaid patients having to pay a small copay/out of pocket, makes sense. Too many entitlement programs in this country leads to people taking advantage and that is what creates the financial mess we are in. I'm glad I don't have anymore Medicaid, such a pain in the butt with little reimbursement. I had one client who was actually LOSING money with Medicaid!
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A couple new items of news.
CMS released the round 2 Competitive Bidding Winners for DME last week.
The Press Release can be found here: http://medbill.net/2013/04/cms-releases-list-of-contract-suppliers-selected-under-medicare-competitive-bidding-program/ (http://medbill.net/2013/04/cms-releases-list-of-contract-suppliers-selected-under-medicare-competitive-bidding-program/)
A major issue is the distance in Miles that many of the bid winners are from the service area. Some of these averages are 400 - 700 miles away.
Also.. i'm not sure if this will get any traction but there was a court ruling recently regarding the patient portion of Medicare Claims. This ruling supposedly opens the door for providers to bill medicare for bad Patient Pay AR. "Opens the Door" is the key phrase here.
read more here:
http://medbill.net/2013/04/court-ruling-opens-door-for-providers-to-seek-reimbursement-for-medicare-bad-debts/ (http://medbill.net/2013/04/court-ruling-opens-door-for-providers-to-seek-reimbursement-for-medicare-bad-debts/)
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any one know what the deal is with this new billing in mental health? I have all the codes but the insurances including medicare keep denying them. I hear this is happening with many doctors seems the insurance companies have no idea what to do with them. So they just send out denials. Can anyone help? Heres the coding i have.
PSY Add on Codes (E/M & Psychotherapy)
90833 Psychotherapy, 30 min
90836 Psychotherapy, 45 min
90838 Psychotherapy, 60 min
CPT Code
90791 New Patient Evaluation No Medical Service
90792 New Patient Evaluation With Medical Service
99212 Evaluation/Management 10 min
99213 Evaluation/Management 15 min
99214 Evaluation/Management 25 min
99215 Evaluation/Medical Management 40 min
I've added the 2 together with a + in the middle as instructed and still denied. Help Please?!
Thank you! Colleen
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I've added the 2 together with a + in the middle as instructed and still denied. Help Please?!
What do you mean the + in the middle.. the plus is only a descriptor in the CPT guide to indicate it's an "add on code". Can you be more specific as to the denials you are receiving, type of provider. Since you are utilizing the E/M I am assuming two things; 1) medication/pharmacological management is being done and the provider type is a prescribe acting within the scope of his license. If using the add on psychotherapy codes it's assumed then there is documented psychotherapy as well being performed. The biggest reason providers are having tough time with these new codes is the E/M, this is ONLY going to affect prescribers! If you are billing for a therapist or non prescribing provider you won't be able to utilize the E/M codes. The prescribers having a problem with this seem to be the ones that never utilized E/M even though MD's (Psychiatrists) were always able to utilize it so long as all elements of the E/M are utilized. I know some other problems were that carriers had not loaded newer fee schedules for a while but for most part all carriers seem to be on board from what I'm seeing. The time thing has a few non prescribers a little confused as well. Need more info as to the denials you are getting.
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An Accredited Medicare DME Provider broke down the Competitive Bidding Results in their are and came up with some really good questions. This is a good read.
http://medbill.net/2013/04/15-questions-to-cbic-from-accredited-medicare-dme-provider/ (http://medbill.net/2013/04/15-questions-to-cbic-from-accredited-medicare-dme-provider/)
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that has nothing to do with mental health billing or her denials.
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that has nothing to do with mental health billing or her denials.
This thread is for industry news. I think ckeenan32104 posted a question in the news thread.
ckeenan32104 may want to repost in a new thread in order to get more responses.
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The Major News keeps coming.
On Thursday Rep. Tom Price introduced H.R. 1717. It has been Referred to the House Committee. The Market Pricing Program Bill would replace Competitive Bidding.
Here is the article with information on the Bill and contact information for Congress Members. Currently HR 1717 has 25 Cosponsors. We need more.
http://medbill.net/2013/04/market-pricing-program-bill-h-r-1717-introduced/ (http://medbill.net/2013/04/market-pricing-program-bill-h-r-1717-introduced/)
Also on Thursday CMS Announced that they will be Delaying the implementation of PECOS Phase 2 Edits.
http://medbill.net/2013/04/cms-delays-pecos-phase-2-implementation/ (http://medbill.net/2013/04/cms-delays-pecos-phase-2-implementation/)
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On Friday it was announced that AAHomecare and NAIMES will be merging. The merger is said to be effective as of May 22nd.
http://medbill.net/2013/04/aahomecare-to-merge-with-naimes/ (http://medbill.net/2013/04/aahomecare-to-merge-with-naimes/)
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The deadline is approaching for competitive Bidding Grandfathering notification.
May 20th is the deadline to meet the 30 day requirement.
http://medbill.net/2013/05/deadline-approaching-for-competitive-bidding-grandfathering-notification/ (http://medbill.net/2013/05/deadline-approaching-for-competitive-bidding-grandfathering-notification/)
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A couple new items of news.
CMS released the round 2 Competitive Bidding Winners for DME last week.
The Press Release can be found here: http://medbill.net/2013/04/cms-releases-list-of-contract-suppliers-selected-under-medicare-competitive-bidding-program/ (http://medbill.net/2013/04/cms-releases-list-of-contract-suppliers-selected-under-medicare-competitive-bidding-program/)
Good articles....
Need to be updated about latest changes and happenings..