Feb 18Recent Chronic Pain AuditsThere have been several recent chronic pain audits our clients are undergoing. 1. Kyphoplasty and Vertebroplasty. Performant...
Nov 16, 2023DHHS Enforcement Actions Involving Anesthesia and Chronic PainDHHS just released its Annual Report for the Health Care Fraud & Abuse Control Program, wherein it detailed the Government’s latest...
Oct 6, 2023Rx Drugs Not Enough for 99214Most pain physicians try to achieve billing 99214 (moderate medical decision making) by relying on the fact that they have prescribed...
Sep 3, 2023UDT Cannot be Billed as Incident toIn a recent TPE (Targeted Probe and Educate) audit that we are defending, Palmetto GBA (one of the Medicare carriers) is taking the...
Jul 18, 2023Medicare Temporary Bundling of UDT Codes1. Medicare Bundling of Screens and Definitive Tests. Effective July 1, 2023, CMS implemented NCCI edits between Column One codes...
Mar 29, 2023New SIJ Injection LCDsFive of the seven Medicare Carriers around the country have adopted a multijurisdictional new LCD for SI Joint Injections (“SIJIs”). The...