CMS has discontinued the 855R credentialing form. The 855R form has been used for over 25 years to reassign Medicare benefits to group...

The following factors should be taken into account when documenting pre-OR time, in room time, and PACU time. 1. START TIME. a. ...

REGISTRATION IS NOW OPEN FOR MEDICAL COMPLIANCE CENTER'S 2024 ANESTHESIA & CHRONIC PAIN COMPLIANCE UPDATES JANUARY 11 & 12, 2024 Each of...

DHHS just released its Annual Report for the Health Care Fraud & Abuse Control Program, wherein it detailed the Government’s latest...

We know that Medicare is allowing, for 2024, the patient to be at home and receive a telehealth service that is billable to Medicare. ...

We recently submitted a request for an official opinion to the AMA regarding whether an abdominal U/S is bundled into the anesthesia base...

1. Virtual Direct Supervision. The 2024 Medicare Physician’s Fee Schedule Final Rule confirms that for 2024, Medicare will continue to...

Medicare is changing how to report place of service codes and modifiers for telehealth services in 2024. For 2023, you reported the...

The Medicare Physician's Fee Schedule Final Rule was released November 2, 2023, in which CMS confirmed that telephone visits remain on...

The 2024 Medicare Physicians Fee Schedule Final Rule (the "Final Rule") was released November 2, 2023. The Final Rule states that the...

There is an urban myth that you can only have one fee schedule. Not true, although you should address the reason for different fee...

Most pain physicians try to achieve billing 99214 (moderate medical decision making) by relying on the fact that they have prescribed...

In a recent TPE (Targeted Probe and Educate) audit that we are defending, Palmetto GBA (one of the Medicare carriers) is taking the...

1. Settlement. On August 24, 2023, the U.S. DOJ released a press release in which it confirmed a $6.5mm settlement with an...

1. Medicare Bundling of Screens and Definitive Tests. Effective July 1, 2023, CMS implemented NCCI edits between Column One codes...

On May 10, 2023, the DEA issued a Temporary Rule regarding using telehealth to issue electronic prescriptions of opioids after the PHE...

CMS has published an update on what PHE flexibilities will be extended after the PHE. I previously reported that telephone only calls...

1. End of the PHE. DHHS is terminating the PHE on May 11, 2023. Many of the PHE waivers will end on May 11; however, some will continue...

Five of the seven Medicare Carriers around the country have adopted a multijurisdictional new LCD for SI Joint Injections (“SIJIs”). The...

Many of you have inquired about using STIMWAVE (“SW”) stimulator products and whether Medicare would pay for them. The DOJ just issued a...

1. Question. Can 93312 be used for a TEE performed in connection with a TAVR (or other transcatheter or intracardiac or great vessel...

Over the past several years, multiple pain physicians have been found guilty of illegally prescribing opioids in violation of the...

1. Types of Blocks Addressed. The AMA has issued new guidance regarding the billing of plane (a/k/a"planar") blocks, including PECS I,...

The 2023 ASA RVG (Relative Value Guide) confirms that for 2023 there are no new anesthesia codes, no deleted anesthesia codes, no changed...