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January 25, 2018

Four Tests Added to List of CLIA Waived Tests

In early January, the Centers for Medicare and Medicaid Services (CMS) announced new waived tests... Learn More

New and Revised Vaccine Codes Added to 2018 CPT Code Book

The American Medical Association (AMA) added and revised several vaccine CPT codes for its 201... Learn More

OIG Recommends Measures for Curbing Opioid Misuse and Fraud

Office of Inspector General testimony before the House Committee on Ways and Means in January ... Learn More

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Medical Coding News Archives

Article Archives 
Please note: archived articles may not reflect current guidelines and regulations.

Broadcast: December 7, 2017
QPP Final Rule Aims to Ease Full Transition to the Payment Program

Broadcast: November 30, 2017
OPPS Final Rule Has G Codes, Discount Drug Payment in Its Sights
PFS Final Rule Highlights
CMS Will Not Implement Home Health Groupings Model

Broadcast: October 31, 2017
CPT Code Changes Include New Modifiers, Chest X-ray Codes
CMS Clarifies Use of Modifier KX for Immunosuppressive Drugs

Broadcast: October 17, 2017
Hospice Compare
October Coding Corner

Broadcast: September 26, 2017
OIG Spots Errors Coding Mechanical Ventilation and RHC with Biopsy
Electronic Health Records (EHRs) Cost Nurses and Physicians Time with Patients
Coding Arthroscopic Shoulder Surgery

Broadcast: September 20, 2017
September Coding Corner

Broadcast: August 31, 2017
CMS Releases Proposed Rule for Physician Fee Schedule Update
Hospitals Gain Another Year to Adopt Latest EHR Technology
Medicare Proposes Moving Total Knee Arthroplasty Off Inpatient-Only List

Broadcast: August 30, 2017
New Website Offers Resources for Transitioning to New MBIs

Broadcast: August 16, 2017
The CMS Innovation Center

Broadcast: July 27, 2017
Highlights of the ICD-10-CM Final Changes Effective October 1
New and Updated HEDIS Measures Address Opioid, Alcohol Use
ESRD Proposed Rule Updates Payment Rates, Tweaks Quality Program

Broadcast: July 17, 2017
July Coding Corner

Broadcast: June 30, 2017
Payment for Chiropractic, Dental Services Among OIG Recommendations to CMS
Quarterly ASC Update Contains New Codes, Payment Indicators
Self-Reporting, Switching Programs Led to Overpayment Under EHR Incentive Program

Broadcast: June 13, 2017
Medical record hacking increases at an astronomical rate
CPT® and HCPCS changes impact observation and recovery
Three important facts about risk adjustment coding

Broadcast: June 12, 2017
June Coding Corner

Broadcast: May 30, 2017
Proposed Rule for IRF, SNF, and Hospice Services Released
CMS Adds Two New HCPCS Codes for Glucose Monitoring
Coverage for Hepatitis B Screenings Extends Beyond Pregnant Women

Broadcast: May 18, 2017
Meeting CMS documentation requirements for HCC coding

Broadcast: April 27, 2017
Coordination and Maintenance Committee Addresses More Changes to Diagnosis Codes for 2018
MS-DRG and ICDE-10 Code Changes for 2018 in a Nutshell
Remember, Nutrition Therapy Is Covered Separately

Broadcast: April 26, 2017
New Initiative Highlights Chronic Care Management for Medicare Beneficiaries

Broadcast: April 12, 2017
Is the Russian mob selling access to your computer?
April Coding Corner

Broadcast: March 15, 2017
FDA Continues to Address Opioid Epidemic
CMS to Test Payment Model for AMI, CABG, Hip/Femur Fractures
Steering Away from Leading Physician Queries

Broadcast: March 14, 2017
How much is risk adjusted coding worth to the Medicare Advantage plans?
Free special report: getting started with the MACRA payment program
March Coding Corner

Broadcast: February 27, 2017
Observation Notice to Outpatients Now Required
Quality of Care Lags Behind Growth of Telemedicine
Hospitalization Rates Drop Among LTC Patients

Broadcast: February 9, 2017
Where to train: E/M coding has the biggest return on investment
February Coding Corner

Broadcast: January 25, 2017
Providers Not to Be Penalized for Quality Measures Affected by ICD-10 Update
Medicare Now Pays for Prolonged Services Without Direct Face-to-Face Patient Contact
CMS Publishes Final Rule for Home Health Agencies

Broadcast: January 18, 2017
Nothing is certain except death and taxes…and auditing!
January Coding Corner

Broadcast: December 7, 2016
The three keys to HCCs and risk adjustment
December Coding Corner

Broadcast: December 1, 2016
Payment for Home Health to Be Contingent on OASIS Starting in April

Broadcast: November 28, 2016
Practices Can Choose Their Level of Participation in the Quality Payment Program
Highlights of the HCPCS Level II Code Update

Broadcast: November 16, 2016
Surprise! You’re the new HIPAA guy! . . . Now what . . .?

Broadcast: October 20, 2016
Separate Coding of Moderate Sedation Among Changes to CPT Codes for 2017
Improve Documentation to Lower Denial Rate of Chiropractic Claims
Providers Must Be Ready for SSN Replacements by April 2018

Broadcast: October 11, 2016
Customers say staffing is key to addressing provider business concerns
October Coding Corner

Broadcast: September 19, 2016
Risk adjustment coding often short changes health plans and participating providers
September Coding Corner

Broadcast: September 18, 2016
Flexible No More—No ICD-10 Grace Period Past October 1

Broadcast: August 24, 2016
CMS Puts Practices on the Alert After Hacking Report
NIH Publishes New Guidelines for Diagnosing Fetal Alcohol Syndrome
CMS Pushes Timeline for Imaging AUC Back Six Months

Broadcast: August 17, 2016
Feds recover funds triggered by clinical documentation improvement
August Coding Corner

Broadcast: July 20, 2016
Famous tennis player sets HIPAA rules in motion 20 years ago
July Coding Corner

Broadcast: June 22, 2016
Medicare Requires Providers to Assign Modifier JW
CMS Posts Interactive Part B Claims Data for 2014
Competition for Best Bill Redesign Is Launched

Broadcast: June 14, 2016
The solution to “monster” GEMs: physician specialty ICD-9 to ICD-10 mapping
June Coding Corner

Broadcast: May 23, 2016
MACRA Proposed Rule Defines Two Part B Payment Tracks
CMS Quality Focus Turns to Primary Care
Errors Estimated to Cause a Quarter Million Deaths Per Year in U.S.

Broadcast: May 10, 2016
What does PQRS spell? …Headache!
May Coding Corner

Broadcast: April 19, 2016
Updates to ICD-10-CM Alter Approach to Coding Certain Conditions
Alternative Payment Model for Part B Drugs to Be Tested This Year
Providers Responsible for Overpayments from Past Six Years

Broadcast: April 18, 2016
New HIPAA audits launched in 2016—targeting policies and procedures
April Coding Corner

Broadcast: March 17, 2016
ICD-10 Code Update for 2017 Described as ‘Code Explosion’
Meaningful Use as Separate Program to End This Year
Case Study: Orbital Atherectomy X Code

Broadcast: March 14, 2016
E/M is the foundation of practice revenue and the key to ICD-10-CM coding accuracy
March Coding Corner

Broadcast: February 16, 2016
February Coding Corner

Broadcast: February 15, 2016
CMS Updates NCCI Manual for 2016
2016 Revisions to HCPCS Focus on Quality Reporting and Drugs Provided
Diagnosis Code for Zika Virus

Broadcast: January 14, 2016
January Coding Corner

Broadcast: January 12, 2016
OPPS Final Rule Addresses Two-Midnight Rule, Restructures ASCs
CMS Drops Plan to Employ VM Checkmark on Physician Compare Website

Broadcast: December 1, 2015
Specialty Focus: OB/GYN—To report trimester or not?

Broadcast: November 30, 2015
Final Rule Expands Access to Services Under Stark
OIG Issues Work Plan for 2016
CMS Adds to List of Reimbursable Telehealth Services

Broadcast: November 10, 2015
Physician queries abound under ICD-10 – but, know when not to query.
November Coding Corner

Broadcast: October 21, 2015
Alert! Paper Claims Must Have Code Set Indicator
Continue to Use Laterality Modifiers Under ICD-10
2016 Radiology CPT Code Update Typified by Bundling, Greater Specificity

Broadcast: October 19, 2015
Coding Quality Check: The top three coding variances for ICD-10-CM and PCS

Broadcast: September 16, 2015
CMS Posts ICD-10 Guides Tailored for Six Specialties
All Systems Go for ICD-10 Claims Processing
ACOs Show That Less Is More in 2014

Broadcast: August 25, 2015
CMS and AMA Team Up to Ease Physician Transition to ICD-10
New Law Requires Notification of Observation Status
Medicare Quality Incentive Programs See Upward Participation Trend

Broadcast: July 31, 2015
Final ACO Rule Expands Participation Tracks in Shared Savings Programs
APMs Have Neutral Financial Effect, Change Care Delivery, Study Finds
Don’t Overcode Dropless Cataract Surgery

Broadcast: June 30, 2015
Fifty New PCS Codes Added for 2016 in Spite of Code Freeze
OIG Report Zeroes in on Hospice Care and CAH Services
E/M Visits More Than a Day Before Surgery May Be Part of Global Period, AMA States

Broadcast: May 29, 2015
Health Care Records Are in Hackers’ Sites
ICD-10’s Impact on Hospital Payments Expected to Be Zero

Broadcast: April 24, 2015
Five New PCS Codes Recommended for Fall 2015 Implementation
Industry Leaders Form Task Force for Payment Transformation
SGR Formula Is Repealed

Broadcast: March 25, 2015
CMS Deems First End-to-End Test of ICD-10 in 2015 a Success
New Lower Endoscopy CPT Codes Not Recognized Under MPFS for 2015
New Care Model Focuses on Chemotherapy Episodes of Care

Broadcast: February 19, 2015
Medicare Now Covers Lung Cancer Screening
Targets Set for Tying Medicare Dollars to Value, Not Volume
EHR Meaningful Use Penalties Affect Half of Eligible Providers

Broadcast: October 23, 2014
New Modifiers Aim to Reduce Modifier 59 Errors
Data Release Reveals Financial Ties in Health Care Industry
Some Will See Reduced Payment in 2015 Under PQRS

Broadcast: August 1, 2014
Medicare PPS for Federally Qualified Health Centers Slated for Fiscal 2015
Health Plan Identification Numbers Finally to Be Implemented

Broadcast: April 3, 2014
Bill Passes for Delaying SGR Fix/ICD-10-Implementation
Medicare Covers PET Aß Scanning Under Certain Circumstances
Medicare Releases April Update to MPFS

Broadcast: March 21, 2014
Impacted Cerumen: Medicare to Deny Claims, Contrary to AMA Coding Instructions
White House 2015 Budget Proposal Gets Push-Back
Report Says Current Trends Indicate Huge Medicare Savings

Broadcast: February 26, 2014
AMA Seeks Reversal of ICD-10 Implementation Mandate from CMS
CMS Begins Testing ICD-10
The Challenge of Coding Complex Chronic Care Coordination

Broadcast: February 13, 2014
2014 OIG Work Plan Released: Physician Services Overview
OIG 2014 Work Plan: Part 2
Changes to Coverage for Ventricular Assist Devices

Broadcast: January 24, 2014
Physician Payment Gets Temporary Boost in 2014
2014 HCPCS Codes Finally Released
New Measure Specs in PQRS Updates for 2014

Broadcast: October 24, 2013
Digestive Chapter Is Focus of 2014 CPT Code Changes
The Government Shutdown and Healthcare
Medical Device Tax Survives Shutdown

Broadcast: August 30, 2013
Observation Part 1: Office of the Inspector General Reviews Observation
Observation Part 2: Presumed Medical Necessity
OIG Examines Critical Access Hospital Locations

Broadcast: July 18, 2013
Primary Care and Complex Chronic Care Management: A Focus of Physician Payment Rule
CMS to Up Quality Reporting Requirements for Some Providers

Broadcast: July 3, 2013
No Rubber Stamp on the Rubber Stamp Signature
Over $100 Million in Medicare Payments for Ineligible Beneficiaries
Expansion of the Senior Medicare Patrol Program Is Proposed

Broadcast: June 20, 2013
New Edit on Physician E/M Codes for New Patients
Technical Component of Physician Pathology Services
OIG Finds Chemotherapy Billing Still Problematic

Broadcast: June 7, 2013
ICD-10-CM Rehabilitation Coding: Where Do We Go?
Coding Clinic Starts Its Transition to ICD-10-CM/PCS
CDC Opts for CPT® Over ICD-10-PCS Codes

Broadcast: May 16, 2013
Proposed Inpatient Payment Regulations Released
HCPCS Code Update
Administration of End-Stage Renal Disease Drugs

Broadcast: May 2, 2013
Medicare Considers Coverage for Lumbar Decompression
Medicare Moves Toward Electronic Documentation Submission
HHS Budget Includes Cost-Cutting Measures

Broadcast: April 19, 2013
Contracts Awarded under Medicare’s Competitive Bidding Program for DMEPOS
CMS to Provide Guidance for Consumers Regarding Health Insurance
Documents Used by Review Contractors

Broadcast: March 29, 2013
New Place of Service Code Effective April 1
CDC Posts Updated New ‘Superbug Health Alerts’
HHS: No Further Delay for ICD-10

Broadcast: March 15, 2013
ICD-9-CM Coordination and Maintenance Committee Code Proposal
Coordination and Maintenance ICD-10-CM/PCS Topic Highlights
ICD-10 Conversion of National Coverage Determinations

Broadcast: February 21, 2013
Medicare Tests Bundled Payments for Care
Health Care Recoveries in 2012 Break Record
New Initiative Aims to Improve End-Stage Renal Disease Care

Broadcast: February 7, 2013
Hospital Value-based Incentive Payment
OIG 2013 Work Plan to Include Hospital Transfers
Report Shows More Doctors Adopting EHRs

Broadcast: January 24, 2013
Multiple Procedure Reductions Apply to More Services for 2013
Therapy and Functional Limitations for 2013
Add-on Codes Fall into Three Categories

Broadcast: January 3, 2013
Update on 2013 Medicare Physician Fee Schedule

Broadcast: December 21, 2012
New CPT Codes for Transitional Care Management Services
Meeting ‘Meaningful Use’ Criteria for Electronic Health Records
Medicare Telehealth Services Expand

Broadcast: December 14, 2012
Payment Error Rates for DME, Physician/Lab/Ambulance Have Largest Jump in 2012
Disaster Recovery Plan–Are You Ready?
The Importance of Errata

Broadcast: November 29, 2012
Observation Is Key Topic in OPPS Final Rule for 2013
Laparoscopic Sleeve Gastrectomy: Change Is Good
Obamacare: Call It What It Is—Patient Protection and Affordable Care Act

Broadcast: November 8, 2012
CPT and the ‘Other Qualified Health Care Professional’
Reduction in 2013 DRG Reimbursement Caused by Readmissions
HHS Being Sued Over RAC Medical Necessity Audits

Broadcast: October 25, 2012
CMS Outlines Enforcement of Documentation Requirements
Medicare Takes Steps to Make NCDs Reflect ICD-10-CM Codes
Fraud Task Force Uncovers $429 Million in False Billing

Broadcast: October 4, 2012
Medicine Section Hardest Hit by CPT Changes for 2013
Medicare Physician Fee Schedule October Update Released
New Unique Health Plan Identifier to Save Almost $6 Billion

Broadcast: September 21, 2012
Final Rule Confirms ICD-10 Delay
2013 Changes to Psychiatric Services Codes
2012 CPT Instruction Added as New Language for 2013 E/M Code Descriptors

Broadcast: September 6, 2012
New Medicare Claim Edit Flags LOS for Continuous Ventilation
Scrutiny of Community Mental Health Centers Continues
Confusing Leuprolide Acetate HCPCS Codes

Broadcast: August 23, 2012
Part A/Part B Rebilling Demonstration Project
Transitional Care Could Have Separate Payment in 2013
Revenue Codes Should Reflect the Cost Center, Not the Place of Service

Broadcast: August 10, 2012
The OIG Audit Finds over $3.3 million of Overpayments for Trastuzumab
Radioisotopes Derived From Non-Highly Enriched Uranium Sources
Therapy Financial Limitations to Apply to Hospital Outpatient Setting

Broadcast: July 27, 2012
CMS Proposes Giving Contractors More Control Over Medical Reviews
Without Congressional Interventional Physicians Could See 27 Percent Payment Reduction
CMS Releases Proposed Rule for OPPS

Broadcast: July 12, 2012
NUCC Seeks Approval for CMS-1500 Revisions
No One Immune to RAC Efforts As Recovered Dollars Soar
Primary Care Incentive Payment Could Significantly Boost Income

Broadcast: June 29, 2012
AMA Creates New Section for MAAA Codes
Increased Payments Aim to Attract Physicians to Medicaid
Six States Move Forward in Preparing for ACA

Broadcast: June 1, 2012
New Codes for Ambulatory Surgery Centers
Low Charges Can Trigger a Review
Coverage of Screening and Counseling for Alcohol Misuse

Broadcast: May 23, 2012
Uncommon Coding: Brown-Sequard Syndrome in ICD-10-CM
Pop Quiz! Proposed Fiscal 2013 Final Rule and Final Addenda
Making the Grade: Translating AAST Organ Injury Scale Score into ICD

Broadcast: May 11, 2012
Ow! Traumatic Fracture Terms in ICD-10-CM
Alert! Differences Between ICD-9-CM and ICD-10-CM Injury Diagnosis Coding

Broadcast: April 27, 2012
Rule Proposes Unique Health Plan and Other Entity Identifiers
ICD-10 Implementation to Be Delayed
Latest Round of CLIA-Waived Tests

Broadcast: April 20, 2012
Modest Edits Made to NCCI
Quarterly HCPCS Level II Update Has Varying Effective Dates
Participation and Payouts Jump for Medicare Incentive Programs

Broadcast: April 5, 2012
CMS Extends Enforcement Discretion Period for Version 5010 Transactions
National Colorectal Cancer Awareness Month Promotes Screening Examinations
I-10 Coding Guidelines for Drug-Induced Conditions Aligned with I-9

Broadcast: March 21, 2012
March 2012 Coordination and Maintenance Committee Code Proposal Highlights
Update: ICD-10-CM/PCS Implementation Delay
MS-DRG Update for ICD-10

Broadcast: March 1, 2012
Affordable Care Act Slashes Drug Costs in First Year
Brush-up on Billing Ambulance Services
Few Localities Plan for Radionuclear Contamination from Terrorist Attack

Broadcast: February 16, 2012
Medicare Covers More Prevention in Primary Care Setting
HCPCS Changes Are Released
Behavioral Therapy for Cardiovascular Disease Now Covered

Broadcast: February 3, 2012
Final Rule Reduces Hurdles to Shared Savings Program Participation
CMS Eases ACO Participation Rules for Safety-Net Providers
Criminal Checks Have Slight Effect on Ability to Fill LTC Jobs

Broadcast: January 25, 2012
Skin Replacement Codes Are Revamped for 2012
Source CPT Changes for 2012
New Standards for Electronic Funds Transfers

Broadcast: January 19, 2012
CMS Expands Three-Day Payment Window
Update to Claim Adjustment Reason and Remittance Advice Remark Codes
The Multiple Procedure Payment Reduction Has Expanded

Broadcast: January 6, 2012
The Holding of 2012 Date-of-Service Claims for Services Paid Under the 2012 Medicare Physician Fee Schedule

Broadcast: December 21, 2011
CMS Policy & Payment Changes for Outpatient Departments and ASCs
Compliance Date for HIPAA Transaction Standards Pushed Back
Affordable Care Act Ensures Patients Get the Most Value for Health Care Dollars

Broadcast: December 6, 2011
MPFS Policy and Rate Changes for 2012 Announced
Obesity Screening and Counseling Is New Medicare Benefit
Upcoming 2012 Changes for Physician Incentive Programs

Broadcast: October 6, 2011
New 2012 ICD-9-CM Volume 3 Procedure Code Highlights
New 2012 ICD-9-CM Diagnosis Code Highlights
New ICD-10-PCS Changes for 2012

Broadcast: August 16, 2011
Status of Telehealth Services in Proposed Rule
Medicare Hospice Care
Help Available for Low Income Beneficiaries for Prescription Drugs

Broadcast: August 2, 2011
Immunotherapy for Metastatic Prostate Cancer Now Covered
Laboratory Edits Updated for Medicare
Staying Current with Coverage Changes for HIV Screening

Broadcast: July 18, 2011
Cancer Hospitals, Therapy Levels Among Issues Addressed in 2012 OPPS Rule
Integrated Care Demonstration for ‘Dual Eligibles’
Skilled Nursing Facility Payments Increased by $2.1 Billion in 2011

Broadcast: July 13, 2011
CMS Modifies Criteria for Reporting Hours of Observation
New Signature Policy for Lab Requisitions May Meet an Early End
Proposed 2012 Medicare Physician Fee Schedule Released

Broadcast: June 7, 2011
CMS Proposes Additional Hardship Exceptions to Electronic Prescribing
HHS Would Allow Patients to View PHI Access Under Privacy Rule
Consumers May Get Access to Comprehensive Quality and Cost Information

Broadcast: May 18, 2011
Proposed Hospital Rules Include Modest Payment Reduction
SGR Payment Method Is Focus of MedPAC Report to Congress
Report Unearths ED Errors When Reporting Imaging Services

Broadcast: April 13, 2011
ePrescribe by June 30 to Avoid Payment Reduction
No Deductible or Coinsurance Applied to Preventive Services As of January 1
Accountable Care Organizations Could Share in Medicare Savings

Broadcast: April 1, 2011
Disclosure Notices to Make Insurance Rate Increases Transparent
HHS Clarifies Medicaid and CHIP Eligibility Issues
HHS Incentive Program Aims for Better Health, Lower Costs

Broadcast: March 18, 2011
CMS Outlines Claim History Data Use by Contractors
April Update to MPFSDB Results in Minor Tweaks Only
CMS Clarifies Outpatient Psych Payment Limitation

Broadcast: March 2, 2011
CMS Updates Additional Documentation Limits At Provider Request
New Rules Proposed for Quality-of-Care Complaints
Rate of Growth in National Health Spending Slows

Broadcast: February 11, 2011
Issues with Annual Wellness Visit Claims Can Result in Denials
2011 Durable Medical Equipment Reimbursement Changes
Changes to Medicare Contractor Numbers

Broadcast: February 4, 2011
Pre-Existing Condition Plan Up and Running
New Documentation Requirements for Home Health Certification Effective Jan. 1
CMS Recognizes Two New Specialty Designations

Broadcast: January 10, 2011
Extenders Act Maintains Conversion Factor, but MEI Still Results in Lower Payment
CMS Mandates Strict Review of ABNs
Electronic Health Record Incentive Program Registration Opens January 3

Broadcast: December 23, 2010
Medicare Covers Annual Wellness Visits Beginning January 1
Timely Filing for Medicare Claims Kicks In

Broadcast: December 6, 2010
New Modifier for Preventive Services
AMA Releases Subsequent Observation E/M CPT Codes for 2011
New Pediatric Immunization Administration Codes Released

Broadcast: November 26, 2010
Providers Dodge Pay Cut for 31 More Days
New HCPCS Codes for 2010–2011 Seasonal Influenza Vaccines
New Specialty Codes for Cardiac Electrophysiology and Sports Medicine

Broadcast: November 12, 2010
Final Rule Cuts Medicare Physician Payment by Nearly a Third
2011 HCPCS Level II Code Set Released
Quality Measures Increase but Incentive Payments Shrink in 2011

Broadcast: October 29, 2010
CMS Releases Reporting Requirements for Tobacco Counseling
OIG Releases Fiscal 2011 Work Plan
Semi-annual Health Care Provider Taxonomy Updates Effective October 1

Broadcast: September 3, 2010
CMS Releases CCI Version 16.3
RAC Complex Review of Part B Claims Is Still on the Horizon
Edits to Verify CAH Provider Enrollment in Medicare

Broadcast: September 2, 2010
Reporting Services Provided at the Patient’s Home
Chiropractic Claims Supplemental Measure Study
Over but Not Forgotten: End of the H1N1 Pandemic

Broadcast: August 16, 2010
Medicare Payment Increase Proposed for Outpatient Departments
A Compromise for Outpatient Therapeutic Services Supervision Requirements
CMS Continues Scrutiny of PHP Payments to CMHCs and OPDs

Broadcast: July 15, 2010
Proposed Changes to PQRI Released
Physicians Receive 2.2 Percent Update Through November 30

Broadcast: June 18, 2010
New ICD-9-CM Code Highlights
Initiative Aims to Save Providers Money and Time
CMS Updates Pulmonary Rehabilitation Services Coverage

Broadcast: June 10, 2010
Pending Payment Legislation Puts Physicians on Hold
AMA Seeks to Block Red Flag Rule
CMS Releases HCPCS Update

Broadcast: May 28, 2010
Conversion Factor Is Adjusted Downward
Reduction Increases for Multiple Procedure Radiology TC
Congress Considers Five-Year Fix to Physician Payment

Broadcast: May 13, 2010
Timely Filing Requirements for Medicare Fee-for-Service Claims
RAC Recoupment Causes Confusion
Matching Funds Awarded for Electronic Health Record Incentive Program

Broadcast: May 4, 2010
No April MPFS Update
CMS Releases PPS Proposed Rules

Broadcast: April 22, 2010
New Diagnosis Code Added to Defibrillator Claim Edits
Inpatient Hospital Billing Changes
Outpatient Therapy Cap Exception Extended

Broadcast: April 6, 2010
CMS Releases Stricter Authentication Guidelines for Medical Reviewers
Claims Error Rate More Than Doubles
OIVIT Remains Noncovered for Medicare Patients

Broadcast: March 16, 2010
Hospital Billing and Coding Changes for Diabetes-Related Treatments
Health IT Certification

Broadcast: February 23, 2010
Medicare Crossover Claims Hit Processing Glitch
New Quality Data Reporting for Renal Dialysis Facilities
Breach Notification Rules Effective February 22

Broadcast: February 9, 2010
Consultation Coverage Change Has Far-Reaching Effects
Confusion Abounds Over New Place-of-Service Guidelines
New Billing Instructions for Qualitative Drug Analysis Testing

Broadcast: January 26, 2010
Medicare Payment Provisions Expire
New Coding, Billing, and Coverage Requirements for Deep Vein Thrombosis

Broadcast: January 12, 2010
New Contractor Numbers Released for Jurisdiction 9
List of CLIA Waived Tests Is Expanded

Broadcast: December 22, 2009
Ambulatory Surgery Centers Prepare for 2010 PPS Updates
CMS Expands PQRI Reporting Options

Broadcast: December 8, 2009
New Payment Rules for Teaching Anesthesiologists and CRNAs

Broadcast: November 24, 2009
Changes in Store for Cardiac and Pulmonary Rehabilitation for 2010
New Coverage Requirements for Inpatient Rehabilitation Services

Broadcast: November 10, 2009
Medicare Coverage for Consultation Codes Is History
PQRI Continues to Grow in 2010

Broadcast: October 27, 2009
CMS Expands MRI Coverage
Accreditations Mandatory for DMEPOS Bids

Broadcast: October 13, 2009
Hospitals Face New Reviews in OIG’s Work Plan for Fiscal 2010
Providers Advised to Verify Medicare Enrollment to Avoid Claim Denials

Broadcast: September 22, 2009
CMS Outlines Local Coverage Determination Exceptions
CMS Has Approved Audit Issues for RACs
Hospitals Accreditation Hinges on Revisions to the Hospital Interpretive Guidelines

Broadcast: September 10, 2009
Updated ICD-9-CM Guidelines Released
AMA/CMS Release Different Coding Advice for H1N1 Vaccinations
CMS Releases October HCPCS Level II Update

Broadcast: August 25, 2009
Deadlines Fast Approaching for DMEPOS Providers
2010 Inpatient PPS Final Rule Released
CMS Is Considering Extending Coverage of Screening Tests

Broadcast: August 11, 2009
Changes Proposed to Hospital Outpatient Physician Supervision Regulations
CMS Clarifies Facet Joint Injections Billing
Screening CTC for Colorectal Cancer Remains Noncovered

Broadcast: July 28, 2009
Physicians Could Take Hard Hit Under Proposed MPFS Rule
OPPS Rule Proposes Payment Increase and Expansion of ASC Services
Medicaid Outpatient Rules Rescinded

Broadcast: July 14, 2009
Lab Coverage Changes Effective July 1
CMS Releases CCI Version 15.2
HIT Policy Committee Proposes Meaningful Use Definition

Broadcast: June 23, 2009
CMS Issues NCD for Wrong Surgery
2010 ICD-9-CM Addendums Released
July Starts New Reporting Period for PQRI

Broadcast: June 9, 2009
Changes Proposed for Acute Care and Long-Term Acute Care Hospitals in Fiscal 2010
CMS Clarifies Billing of Routine Foot Care
Project Targets Unnecessary Hospital Readmissions

Broadcast: May 26, 2009
ICD-9-CM Code Changes for 2010
Coverage Changes for Oncologic Use of FDG-PET
Specialty Code Requirements Revised

Broadcast: May 12, 2009
The Joint Commission Updates Hospital COP-related Requirements
CMS Expands Editing for Ordering/Referring Providers
List of Approved Telehealth Services Is Updated

Broadcast: April 28, 2009
CMS Offers Pay-for-Performance to Nursing Homes
Top Reasons for Unsuccessful PQRI Reporting
BMI Key to Medicare Coverage of Bariatric Procedures in Diabetic Patients

Broadcast: April 14, 2009
CMS Issues ASC Payment Policy Changes Effective April 2009
OIG Recommends Recovery of More Than $4 Million in Overpayments
CMS to Hold Open Door Forum on Part B RAC Audits

Broadcast: March 24, 2009
GAO Releases New Report on Improper Payments in Home Health
Access to Emergency Medical Services Act
CCI April Update and Modifier 59

Broadcast: March 10, 2009
Stimulus Bill Puts EMRs on the Horizon
CMS Releases April Update to MPFS
New CLIA Waived Tests Released

Broadcast: February 24, 2009
Payers to Scrutinize Payments for Modifier 79
Facet-Joint Injections Often Don’t Meet Payment Requirements
Anti-Markup Payment Limitations Outlined

Broadcast: February 10, 2009
CMS Issues Three NCDs Preventing Medicare Payment for ‘Never Events’
Providers Not Up on CCI Edits Risk Accusations of Bundling
Growth in National Health Spending Is Lowest Since 1998

Broadcast: January 27, 2009
Date Set for ICD-10-CM and ICD-10-PCS Implementation
CMS Releases Updates to MPFS/Clinical Lab Fee Schedules
Internet-Based Medicare Enrollment Is Now Available

Broadcast: December 23, 2008
Partial Hospitalization Program Coding
Therapy Billing
Be Aware of FY2009 MS-DRG Relative Weight Revisions

Broadcast: December 9, 2008
2009 HCPCS Level II Update: New Codes
2009 HCPS Update: Revisions, Reinstatements, Deletions
HCPCS Changes to PQRI Codes

Broadcast: November 25, 2008
CMS Updates Remittance Advice Remark Codes
Originating Telehealth Sites and Services Expanded
CMS Releases 2009 Medicare Deductibles

Broadcast: November 11, 2008
CMS Releases Update to Physician Fee Schedule for 2009
Outpatient and ASC Final Rules Released
Physician Final Rule Expands Quality Reporting, Increases Incentives

Broadcast: October 28, 2008
Fall Brings Sweeping Changes to CPT 2009
CMS Tells Physicians to Be Patient
CMS Analyzes Coverage of Screening Colonography

Broadcast: October 14, 2008
NPI Not Required on Certain Claims
There’s No Going Back After Transition to EFT
CMS Publishes MUE Edits

Broadcast: September 23, 2008
OIG Recommendation to CMS: Expand CERT Review Process
More Than 30 Registries Qualify for 2008 PQRI Reporting
CMS Clarifies Rules for Diagnostic Test Orders

Broadcast: September 9, 2008
Migraine Coding for 2009
Three Years Until ICD-10?
FDA Approves 2008–2009 Flu Vaccines

Broadcast: August 26, 2008
CMS Proposes Multiple Imaging Composite APCs
CPAP for Obstructive Sleep Apnea Treatment Now Covered
New Diagnosis Codes for Secondary Diabetes

Broadcast: August 12, 2008
CMS Announces New Coverage of Home PT Monitoring
CMS Announces PQRI Payout
Incorrect POS May Result In $1.5 Million In Overpayments

Broadcast: July 22, 2008
Congress Averts Physician Pay Cut
RAC Demo Saves Medicare Nearly $700 Million
Independent Laboratories Not to Receive Medicare Payments

Broadcast: July 8, 2008
Proposed Reduction to Medicare Physician Fee Schedule for 2009
Proposed Fee Schedule Rule Indicates PQRI Expansion

Broadcast: June 24, 2008
Medicare Travel Allowance Fees for Specimen Collection
New Waived Tests Under CLIA
Electronic Health Records Demonstration

Broadcast: June 10, 2008
New ICD-9-CM Codes for Fiscal 2009
Sneak Peek at CPT® Changes Daunting
CMS to Providers: Register Now to Access Your 2007 PQRI Report

Broadcast: May 27, 2008
New ABN Replaces Three Previous Forms
CMS Releases Fiscal 2009 IPPS Proposed Rule
Expansion of Hospital Quality Program Is Proposed

Broadcast: May 13, 2008
CMS Makes PQRI Participation Easier
Incident-to Policy Is Beefed Up
PRP Wound Treatment Remains Noncovered Under New Policy

Broadcast: April 22, 2008
Acute Care Episode Demonstration Project Effective October 1
No Coverage Change for PTA of Renal Arteries
CMS Releases Updates to HCPCS

Broadcast: April 8, 2008
Starting April 1, Claims Missing POA Indicators Will Be Returned
CMS Announces MAC Contract for Connecticut and New York
CTA Coverage Not to Be Limited As Proposed

Broadcast: March 25, 2008
Time for a HIPAA Compliance Check-up
Medicare Implements the Revised ABN
Get Re-Acquainted with Critical Care Billing and Documentation Requirements

Broadcast: March 11, 2008
RAC Program Identifies $371.5 Million in Improper Medicare Payments
CMS to Provide Prior Determination of Coverage
Bone Mass Measurement Tests Are Inappropriately Denied

Broadcast: February 26, 2008
Correct Critical Care Billing Still Up in the Air
CMS to Implement New Edit in Carrier Processing System
New K Code for Orthosis Interface

Broadcast: February 12, 2008
CMS Contingency Plan Coming to an End
ACE Demonstration Project Launched
Remember to Bill Smoking and Tobacco Cessation Counseling

Broadcast: January 22, 2008
New CERT Report Reveals E/M Errors Remain High
Remember CLIA Allows Providers to Perform PPMP
Coverage Updated for ESA Treatment

Broadcast: January 8, 2008
Physicians Get Extension for Participation Decisions
CMS Publishes Rule Delaying Anti-Markup Provisions
Providers May See New Reasons for Claim Denials in 2008

Broadcast: December 26, 2007
Congress Passes Legislation To Prevent Physician Reimbursement Cut
New Correct Coding Edits Incorporate CPT® Changes
Modifier 51 Revisions Affect the Bottom Line

Broadcast: December 11, 2007
CMS Makes APC Reassignments
Medicare to Pay for Brachytherapy Sources and Application
Coverage Limited for Alcohol and Substance Abuse Assessment and Intervention

Broadcast: November 27, 2007
CMS Creates Composite APCs for Observation
New Place-of-Service Code for Temporary Housing
Status Codes Offer Greater Specificity

Broadcast: November 13, 2007
Physician Payment Takes Major Blow for 2008
Outpatient Prospective Payment Rule Released
CMS Releases PQRI Measures for 2008

Broadcast: October 30, 2007
AMA Adds Codes for Telephone Services
New CPT® Changes Include Modifier Revisions/New Modifier
CMS to Reject Electronic Claims with Legacy Numbers

Broadcast: October 16, 2007
2008 OIG Workplan Released
New I-9 Code for CRBSI Proves Tricky for Coders
Updates to MPFS Released

Broadcast: September 25, 2007
Sneak Peak at CPT® 2008 Reveals Numerous Changes
Implementation of MS-DRGs Begins October 1st
Medicare Releases or Reviews Three NCDs

Broadcast: September 11, 2007
POA Indicator a Must Beginning October 1
CMS Takes Additional Steps in Refining NPI Usage
Fraudulent Infusion Therapy Providers Put in the Hot Seat


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