Author: Mario P. Fucinari DC, CPCO, CPPM, CIC

NGS Clarifies -59 Modifiers

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jun 29, 2015 | Coding, Medicare and Medicaid, Videos, zall | 0 |

This video will help chiropractic physicians understand how to account for the X modifier codes that have replaced the -59 modifier billed to NGS/CMS.

Are Your Medicare Notes Functional

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jun 8, 2015 | Insurance, Medicare and Medicaid, zall | 0 |

Many are seeing increased denials of care for medical necessity in Medicare. A closer look at the reasons for the denials reveals a change in Medicare’s interpretation of medical necessity and progress in care. The evolution of their interpretation actually complements what chiropractors have been saying for several years – we do not only treat pain!

59 Modifier Comes Under Fire in Medicare

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Apr 8, 2015 | Medicare and Medicaid, zall | 0 |

The 59 modifier is used to indicate to the carrier that a “distinct procedure code” is involved and the procedures should be paid separately.

Is Your Practice Guilty of Deflate-Gate

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Apr 8, 2015 | Coding, Insurance, zall | 0 |

Many can say that some in practice may be guilty of “Deflate-gate” by not following regulations, thus cheapening the quality of care they deliver and maybe even giving them an illegal edge.

Is PQRS Really Worth It?

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Mar 19, 2015 | Medicare and Medicaid, zall | 0 |

To help cut down on the costs of health care in Medicare, the government is enacting programs to enhance the value of its purchasing dollars in health care.

ICD-10 Final Rule Released

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Dec 1, 2014 | Coding, zall | 0 |

The Centers for Medicare and Medicaid Services (CMS) has recently released its final rule indicating implementation of ICD-10 will occur on October 1, 2015.

Congress Kicks the Can Down the Road; Delays ICD-10 for One Year

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jun 18, 2014 | Billing and Collections, Documentation, ICS Message, Insurance, Practice Management, zall | 0 |

Congress voted to institute a 1-year “doc fix” preventing a 24% pay cut for physicians who treat Medicare patients. This is the 17th patch in 11 years whereby Congress delayed the “doc fix.” Although there was strong bipartisan support in both the House and Senate to repeal the Sustainable Growth Rate (SGR) formula responsible for the problem, the doc fix was enacted again. President Obama signed into law the Protecting Access to Medicare Act of 2014 on April 1, 2014.

Get, Ready, Audits are on the Rise

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jun 17, 2014 | Insurance, Medicare and Medicaid, zall | 0 |

The Department for Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) have the responsibility to make sure that the funds are properly protected. To this end, they have contractors who audit charts to prevent fraud and abuse. Among them are the Zone Program Integrity Contractors (ZPICS), who audit Medicare A and B, hospice home health, and durable medical equipment programs.