Medicare Credentialing Changes
CMS has discontinued the 855R credentialing form. The 855R form has been used for over 25 years to reassign Medicare benefits to group...
top of page
- Dec 6, 2023
Documenting Anesthesia Time
The following factors should be taken into account when documenting pre-OR time, in room time, and PACU time. 1. START TIME. a. ...
- Nov 30, 2023
MEDICAL COMPLIANCE CENTER'S 2024 ANESTHESIA & CHRONIC PAIN WEBINARS
REGISTRATION IS NOW OPEN FOR MEDICAL COMPLIANCE CENTER'S 2024 ANESTHESIA & CHRONIC PAIN COMPLIANCE UPDATES JANUARY 11 & 12, 2024 Each of...
- Nov 16, 2023
DHHS Enforcement Actions Involving Anesthesia and Chronic Pain
DHHS just released its Annual Report for the Health Care Fraud & Abuse Control Program, wherein it detailed the Government’s latest...
- Nov 12, 2023
Billing Telehealth from Home
We know that Medicare is allowing, for 2024, the patient to be at home and receive a telehealth service that is billable to Medicare. ...
- Nov 11, 2023
Gastric U/S is Not Bundled for Anesthesia
We recently submitted a request for an official opinion to the AMA regarding whether an abdominal U/S is bundled into the anesthesia base...
- Nov 9, 2023
Telehealth Incident to Billing
1. Virtual Direct Supervision. The 2024 Medicare Physician’s Fee Schedule Final Rule confirms that for 2024, Medicare will continue to...
- Nov 7, 2023
Changes to Medicare Telehealth Modifier and Place of Service Codes
Medicare is changing how to report place of service codes and modifiers for telehealth services in 2024. For 2023, you reported the...
- Nov 6, 2023
Telephone Visits for 2024
The Medicare Physician's Fee Schedule Final Rule was released November 2, 2023, in which CMS confirmed that telephone visits remain on...
- Nov 5, 2023
New Medicare Conversion Factors for 2024
The 2024 Medicare Physicians Fee Schedule Final Rule (the "Final Rule") was released November 2, 2023. The Final Rule states that the...
- Nov 5, 2023
Should You Have a Different Fee Schedule for Medicare?
There is an urban myth that you can only have one fee schedule. Not true, although you should address the reason for different fee...
- Oct 6, 2023
Rx Drugs Not Enough for 99214
Most pain physicians try to achieve billing 99214 (moderate medical decision making) by relying on the fact that they have prescribed...
- Sep 3, 2023
UDT Cannot be Billed as Incident to
In a recent TPE (Targeted Probe and Educate) audit that we are defending, Palmetto GBA (one of the Medicare carriers) is taking the...
- Sep 3, 2023
Unnecessary Moderate Sedation Settlement
1. Settlement. On August 24, 2023, the U.S. DOJ released a press release in which it confirmed a $6.5mm settlement with an...
- Jul 18, 2023
Medicare Temporary Bundling of UDT Codes
1. Medicare Bundling of Screens and Definitive Tests. Effective July 1, 2023, CMS implemented NCCI edits between Column One codes...
- May 23, 2023
New DEA Rules on Telehealth Rx of Narcotics
On May 10, 2023, the DEA issued a Temporary Rule regarding using telehealth to issue electronic prescriptions of opioids after the PHE...
- May 3, 2023
Update on Telephone Only Calls 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...
- Apr 19, 2023
End of the PHE
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...
- Mar 29, 2023
New SIJ Injection LCDs
Five of the seven Medicare Carriers around the country have adopted a multijurisdictional new LCD for SI Joint Injections (“SIJIs”). The...
- Mar 15, 2023
STIMWAVE Former CEO Indicted
Many of you have inquired about using STIMWAVE (“SW”) stimulator products and whether Medicare would pay for them. The DOJ just issued a...
- Feb 28, 2023
Cannot Downcode 93355 to 93312
1. Question. Can 93312 be used for a TEE performed in connection with a TAVR (or other transcatheter or intracardiac or great vessel...
- Feb 20, 2023
Prescribing Excessive Opioids
Over the past several years, multiple pain physicians have been found guilty of illegally prescribing opioids in violation of the...
- Feb 2, 2023
AMA Issues New Coding Guidance on Planar Blocks
1. Types of Blocks Addressed. The AMA has issued new guidance regarding the billing of plane (a/k/a"planar") blocks, including PECS I,...
- Jan 23, 2023
Overview of 2023 ASA RVG
The 2023 ASA RVG (Relative Value Guide) confirms that for 2023 there are no new anesthesia codes, no deleted anesthesia codes, no changed...
bottom of page