Medicare Covers Transcutaneous Electrical Nerve Stimulator (TENS) ONLY for Back Pain
Oct27

Medicare Covers Transcutaneous Electrical Nerve Stimulator (TENS) ONLY for Back Pain

Medicare Covers Transcutaneous Electrical Nerve Stimulator (TENS) ONLY for Back Pain In June 8, 2012, CMS issued a Medicare National Coverage Determination (NCD) that allows coverage of Transcutaneous Electrical Nerve Stimulation (TENS) for chronic low back pain (CLBP) only when the patient is enrolled in an approved clinical study within three years after the June 8, 2015 under coverage with evidence development (CED) that meets the criteria outlined below. It only allows coverage for TENS use in the treatment of Chronic Low Back Pain (CLBP) only under specific conditions which are described in the NCD Manual, Pub. 100-03, chapter 1 Section 160.27. Read More about the Decision Memo for a Complete Guideline – CLICK HERE! Searched Keywords: Medicare Covers Transcutaneous Electrical Nerve Stimulator (TENS) ONLY for Back Pain Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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Free Webinar Medical Practice Billing, Cashflow… June 06, 2015.
Jun01

Free Webinar Medical Practice Billing, Cashflow… June 06, 2015.

On my 10th Year Anniversary as a Blogger and Providing Value to the Medical Practice Industry (since 2005)! I am inviting you, your practice and your staff to join my FREE LIVE WEBINAR on “Medical Practice Cash Flow, Revenue Cycle, Billing, Patients’ Payments Collection and Reimbursement Management” June 06, 2015 SATURDAY at 2:00 P.M. Eastern Standard Time YOU WILL LEARN: How to Improve your Daily Cash Flow and Maximize Reimbursement How to Efficiently Manage your Revenue Cycle Understanding your Practice Analysis Reports and Accounts Receivables How to Minimize Claims Denials and Rejection. Learn how to use tools such as the CCI Edits, Medicare and Commercial Payers Reimbursement Guidelines, Insurance Benefits and Eligibility Verification How to Use Some Useful Medical Modifiers How to Appeal your Claims and Get Paid for your Services. Understanding the General Concepts/Process on Workers Compensation and Motor Vehicle Claims and how to properly submit them to avoid payments delay. How to Efficiently Collect Patients’ Responsibility and Account Balances (In-Network or Out-of-Network) Please share this event to your friends and colleagues who might benefit from it. REGISTER HERE -> CLICK HERE   Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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Obesity Medicine Medical Billing, Coding and Reimbursement
Mar22

Obesity Medicine Medical Billing, Coding and Reimbursement

My 2 days Speaking Event at the Obesity Medicine Conference in Washington DC was a big success. Met a lot of physicians who just love what they do and so passionate in providing ONLY the best quality care for their patients. Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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Medicare G0473 New Code for Obesity Treatment
Mar19

Medicare G0473 New Code for Obesity Treatment

Medicare G0473 New Code for Obesity Treatment Professional Billing Requirements:  (Effective January 05, 2015) CMS will allow coverage for: Face-to-Face Behavioral Counseling for Obesity, 15 minutes, (G0447), Face-to-Face behavioral counseling for obesity; Group (2-10), 30 minute(s) (G0473), along with 1 of the … ICD-9 codes for BMI 30.0-BMI 70 (V85.30- V85.39 and V85.41-V85.45) Make sure you use and cross over your DX as shown above!  List of Eligible Specialty 01 – General Practice 08 – Family Practice 11 – Internal Medicine 16 – Obstetrics/Gynecology 37 – Pediatric Medicine 38 – Geriatric Medicine 50 – Nurse Practitioner 89 – Certified Clinical Nurse Specialist 97 – Physician Assistant Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

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CMS New Rule for Place of Service Coding for Physician Professional Component in 2013

CMS New Rule for Place of Service Coding for Physician. Effective April 1, 2013 – CMS had released a new rule on Revised and Clarified Place of Service (POS) Coding Instructions: CMS New Rule for Place of Service Coding for Physician Part of the Instructions are as follows (Source: MLN Matters Number MM7631 Related Change Request Number 7631) “CR7631 establishes that for all services – with two (2) exceptions — paid under the MPFS, that the Place of Service code to be used by the physician and other supplier will be assigned as the same setting in which the beneficiary received the face-to-face service. Because a face-to-face encounter with a physician/practitioner is required for nearly all services paid under the MPFS and anesthesia services, this rule will apply to the overwhelming majority of MPFS services. In cases where the face-to-face requirement is obviated such as those when a physician/practitioner provides the PC/interpretation of a diagnostic test, from a distant site, the Place of Service code assigned by the physician /practitioner will be the setting in which the beneficiary received the (Technical Component (TC) of the service. For example: A beneficiary receives an MRI at an outpatient hospital near his/her home. The hospital submits a claim that would correspond to the TC portion of the MRI. The physician furnishes the PC portion of the beneficiary’s MRI from his/her office location – Place of Service Code 22 will be used on the physician’s claim for the PC to indicate that the beneficiary received the face-to-face portion of the MRI, the TC, at the outpatient hospital.” “There are two (2) exceptions to this face-to-face provision/rule in which the physician always uses the POS code where the beneficiary is receiving care as a registered inpatient or an outpatient of a hospital, regardless of where the beneficiary encounters the face-to-face service. The correct POS code assignment will be for that setting in which the beneficiary is receiving inpatient care or outpatient care from a hospital, including the inpatient hospital (Place of Service code 21) or the outpatient hospital (Place of Service code 22). In other words, reporting the inpatient hospital POS code 21 or the outpatient hospital POS code 22, is a minimum requirement for purposes of triggering the facility payment under the PFS when services are provided to a registered inpatient or an outpatient of a hospital respectively. If the physician/practitioner is aware of the exact setting the beneficiary is a registered inpatient (or hospital outpatient), the appropriate inpatient POS code (or appropriate outpatient POS code) may be reported consistent with the code list annotated in Pub. 100-04, Medicare Claims Processing Manual, Chapter 26, Section 10.5. However, it is more important that the physician/practitioner report the POS consistent with the patient’s general inpatient or outpatient hospital status than the precise inpatient/ outpatient Place...

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