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9th Circuit Approves QZ for Incomplete Medical Direction
New Decision. On June 3, 2025, the federal 9th Circuit Court of Appeals ruled that modifier QZ was legally appropriate in cases where...
Jun 9
Using ChatGPT for Medical Records
I have some clients who have started using ChatGPT to create office visits notes. The notes, after being created, are inserted into the...
May 12
Extension of Telehealth Flexibilities
Telehealth flexibilities have been extended through September 30, 2025. The new "Full-Year Continuing Appropriations and Extensions Act,...
Mar 17
New Nationwide Knee Injection Audit
1. New Nationwide Knee Injection Audit. There is a new nationwide audit for knee injections using hyaluronic acid (“HA”). The...
Mar 16
How are Lumbar ESP and QL Blocks Coded?
Requested AMA Opinion . Recently a client requested that we write the AMA to get a formal opinion on whether lumbar ESP blocks and...
Feb 10
Telehealth Flexibilities Extended by Congress
On December 21, President Biden signed into law a Continuing Resolution (“CR”) that provided enough money to allow the government to...
Dec 31, 2024
Disclosure of Reproductive Health Care PHI
Although it isn't likely that anesthesia or pain management practices will receive a request for PHI relating to reproductive healthcare,...
Dec 6, 2024
HIPAA Fine & 4 Recommended Solutions
$1.19mm Fine . A pain practice in Florida just paid a $1.19 million fine for a self-reported HIPAA violation. The pain practice...
Dec 5, 2024
Telehealth Extension for Prescribing Drugs
I have received several questions about the recent extension of telehealth flexibilities as it relates to prescribing controlled...
Dec 3, 2024
Clarification on Home Telehealth
In my last article, I summarized the 2025 Medicare Physician’s Fee Schedule Final Rule, and its provisions on telehealth which allowed,...
Nov 12, 2024
How to Code Plane Blocks
The 2025 CPT Code has adopted 6 new codes for plane blocks. There are codes for unilateral, bilateral, single shot, and continuous...
Nov 8, 2024
2025 Medicare Final Rule
On November 1, 2024, Medicare posted its 2025 Medicare Physician's Fee Schedule Final Rule, consisting of over 3,000 pages. Below is a...
Nov 6, 2024
Epidural Denials Due to Steroids
1. Epidural Denials . In a recent Medicare TPE audit (Targeted Probe & Educate) one of my clients had all 40 ESI claims denied...
Aug 19, 2024
Rx Drug Management for 99214
Listing the Patient’s Medications. Many physicians think that if they document in their progress notes a list of the medications the...
Aug 13, 2024
Anthem BCBS Reduces CRNA Reimbursement
1. CRNA Reimbursement Reduced . Anthem BCBS is reducing CRNA reimbursement to 85% effective November 1, 2024, for most of the states...
Aug 9, 2024
FTC Bans Non-Compete Agreements
On April 23, 2024, the U.S. Federal Trade Commission ("FTC") adopted a rule (the “Rule”) to ban non-compete agreements with workers....
Aug 7, 2024
New Medicare Rules on Billing QMBs
Medicare just updated its MLN Fact Sheet regarding billing QMBs (i.e., “Qualified Medicare Beneficiaries” who are dually eligible for...
Aug 1, 2024
New Onerous Requirements for POP Blocks
1. TPE Audit of Blocks. One of the Medicare carriers, Noridian (MAC for all states in the western US), is conducting a TPE (Targeted...
Jun 29, 2024
Are Student AAs the Same as SRNAs?
Issue. There is no national CMS rule as to whether Medicare will reimburse anesthesiologists the same for supervising or medically...
Jun 12, 2024
Noridian Denies Preoperatively Placed Brachial Plexus Blocks
1. Noridian Denials. In a recent audit of one of our clients the Carrier Medical Director for Noridian (Medicare carrier for most of...
Jun 11, 2024
ALJ Opinion on PNS and Psych Codes
1. ALJ Opinion. On May 30, 2024, an Administrative Law Judge (“ALJ”) rendered an opinion in a case in which I was involved relating...
Jun 7, 2024
Update on Change Healthcare Breach
Some of you have been affected by the Change Healthcare breach, and I have previously advised you that the OCR views this as a breach...
Jun 1, 2024
HIPAA Amendments re Reproductive Health Care
To combat states from using PHI to investigate patients and physicians for legal abortions, the OCR released a Final Rule which...
May 4, 2024
Audits of Levels and Sides of Injections
1. Procedure Title vs Procedure Detail. In a recent audit of one of our clients, Medicaid auditors disallowed epidural and facet...
Apr 23, 2024
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