Although multiple segments or regions may be involved in the cause of a patient’s ailment, it is important to identify the main segment or region and report the diagnosis specifically. Medicare has recently reaffirmed that duplication of diagnoses in Box 21 on the claim form will be denied. Each area treated must have a unique diagnosis.
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Congress passed the Bipartisan Budget Act of 2018 on 2/9/2018, changing the Medicare physician fee schedule and the processing of Medicare services. Section 50201 of this Act has made a change to the work Geographic Practice Cost Index (GPCI) floor, effective retroactive to 1/1/2018. Any area that previously was in an area with a work GPCI of less than 1.000 will be impacted.
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On January 1, 2018, the Centers for Medicare and Medicaid Services (CMS) released MLN Matters Number: MM10176. In this notice, CMS identified certain services subject to the therapy cap. The revision became effective on January 1, 2018. Due to this revision, some providers have begun to receive claim rejections because they are not using the appropriate modifier.
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On November 2nd, the Centers for Medicare & Medicaid Services (CMS) issued the final rule with comment for the second year of the Quality Payment Program (calendar year 2018), as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), as well as an interim final rule with comment.
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The Centers for Medicare & Medicaid Services (CMS) has released images of the newly designed Medicare card. The new Medicare card contains a unique, randomly-assigned number that replaces the current Social Security-based number.
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The demands of practice can often be daunting. We know we should take care of ourselves and take a break once in a while. Getting away is not always practical. Overhead is still present, the staff doesn’t always keep to our schedule because of family obligations, and of course, the patients seemingly want us on call 24/7. We can hire another doctor to practice in the office with us, but it is hard to find someone that the patients love who practices in the same style as we do. Then, of course, we have government and insurance regulations. Certification for another doctor for Medicare, PPO restrictions and credentialing can be tedious, especially when we just want them to fill in on a temporary basis.
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The Centers for Medicare and Medicaid Services (CMS) announced today that they intend to further raise the threshold for participation in its Merit-Based Incentive Payment System (MIPS). In its much-anticipated proposed 2018 rule for the Quality Payment Program (QPP), CMSproposed to increase the threshold to exclude MIPS-eligible clinicians or groups with $90,000 or less in Part B-allowed Medicare charges or 200 or fewer Part B Medicare beneficiaries.
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Identity theft has become a major problem in the United States. As a prevention measure, the Centers for Medicare & Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft and safeguard taxpayer dollars.
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