On January 24, 2019, CMS released an update of its Date of Service (“DOS”) rules, i.e., when to bill services such as radiology, labs,...

The AMA recently clarified in its December 2018 issue of the CPT Assistant whether an erector spinae block for post-op pain can be billed...

The AMA recently clarified in its December 2018 issue of the CPT Assistant , whether a trigger point injection performed bilaterally can...

In the December 2018 issue of the CPT Assistant, the AMA issued instructions on how to bill for injection of steriod into the sciatic...

I. Overview. This article will outline changes affecting pain practices in 2019 relating to: (1) Medicare reimbursement for pro fees...

Applicability of Statute. Effective October 24, 2018, a new federal criminal statute went into effect directed at, among other things,...

1. Changes in Medicare Reimbursement. There were slight increases in the Medicare conversion factor (“CF”) from 2018. The anesthesia CF...

On November 1, 2018, CMS released the Final Rule for the 2019 Medicare Physicians Fee Schedule. The scope of this article is limited to...

Not all payers allow "incident to" billing. "Incident to" billing is a Medicare billing methodology which pays the practice 100%, even...

1. Proposed Rule Changes Payment for and Documentation of E/M Codes. Medicare is proposing to change the way it pays for E/M codes and...

Effective 2/23/18, all Medicare providers previously under Cahaba's jurisdiction will now be under Palmetto's jurisdiction. When you log...

On February 1, 2018, Anthem published a new coverage policy which restricts the use of monitored anesthesia care (“MAC”) and general...

In December 2015, the AMA issued an opinion indicating that the injection of the superior medial, lateral, and inferior branches of the...

In the article we wrote this morning about the AMA's changed position on genicular nerve RFs, I need to distinguish between Medicare and...

This month the OIG just updated its "Work Plan" for 2018 by adding "Off-the-Shelf Orthotic Devices" to the Work Plan. The OIG will...

1. Changes to ASA Crosswalk. There were a number of changes in the 2018 version of the ASA's Crosswalk. Many were not significant, but...

The list below contains anesthesia codes where the base unit values are different in the ASA RVG when compared to CMS for 2018. All...

In 2017, the OCR assessed fines and exacted settlements in 10 cases that it reported on its website, and also issued new guidance on 5...

UDT Confirmation Reimbursement. Medicare reimbursement for confirmation codes G0480-83 will be reduced 10% per year for the next 3...

1. Code Deletions and Additions. For 2018, ASA codes 00740 (upper GI) and 00810 (lower GI) are deleted, and in their place are 5 new...

On September 22, 2017, CMS released a proposed material reduction to the Clinical Laboratory Fee Schedule (“CLFS”), affecting urine drug...

Medicare released a new MedLearn Article (MM9815) on September 1, 2017 clarifying the rules on stopping Medicare from recouping money...

On June 28, 2017, Medicare issued an amendment to the QMB (Qualified Medicare Beneficiary) rules. It is illegal to bill a QMB (patient...

On June 8, 2017, the OCR released 2 documents designed to instruct CEs (Covered Entities) and BAs (Business Associates) what to do in the...