Please help I am new to pain management and we are getting denials for CPT code 64447 and 64450- 51 they were both coded with M16.11 and CMS is denying- I do not see that there is an LCD in place for either code
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Tag Archives: Being
[Announcement] NCCI Has Removed the Current Edit Prohibiting 77295 and 77300 from Being Reported Together
CMS and the NCCI has removed the current edit prohibiting the reporting of CPT codes 77295 and 77300 together, effective July 1, 2016. The change will be finalized in the July version of the NCCI Manual and will be retroactive to January 1, 2016. Reporting requirements may vary by payer:
Claims reported to Medicare contractors:
Claims for CPT codes 77295 and 77300 should not be reported together until the edit is removed on July 1, 2016. Practice billing systems can begin capturing charges for 77300; however, the charges should not be released to Medicare until July 1, 2016. All prospective and retrospective pending charges for 77300 may be released on or after July 1, 2016.
Claims reported to private payers:
Depending on state guidelines and individual payer policies, some private payers may not permit claims to be submitted after a certain period of time has passed. Therefore, practices could consider submitting charges for 77300 to commercial payers prior to July 1, 2016. Refer to your payer’s individual reporting policies for guidance on when to submit claims for 77295 and 77300.
Click here to read the original article on the prohibition of reporting 77295 and 77300 together.
The Medical Management Institute – MMI – Medical Coding News & MMI Updates
Brown bagging- being shipped straight to the office.
Hello, I am checking to see if there are any Rheumatology offices that have the patient’s medications for infusions and high-end injections shipped from a Specialty pharmacy to their office? I am not in the clinic, but have been asked to obtain information. We seem to be losing money on Synvisc One. Any information would be helpful. Thank you in advance.
Avoid Being the Next Kickback and False Claims Defendant
Let a case show you why it’s important for your healthcare system to Implement effective compliance programs. By Ann M. Bittinger, Esq. United States of America ex rel. Baklid-Kunz v. Halifax Hospital Medical Center is one case in a recent series in which U.S. attorneys sued health systems for paying kickbacks to their employed physicians, […]
AAPC Blog
Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions
LOUISVILLE, KY – MD2U Holding Company, including its related companies and individually named owners (“Defendants”), have agreed to pay millions to resolve a government lawsuit alleging that they violated the federal False Claims Act by knowingly submitting false medical claims to Medicare and other government health care programs, altering records to support false claims, and providing services that were medically unnecessary U.S. Attorney John E. Kuhn, Jr. today announced….
MD2U also utilized an electronic medical records (EMR) system that permitted the NPPs to easily electronically cut, copy and paste medical notes from prior visits. The ability to migrate notes from visits that occurred weeks, months, or even years prior to the current patient encounter created the illusion that MD2U’s NPPs were performing a significant amount of work during their patient encounters when, in fact, they were not. If the documentation was deficient to bill the highest level code, MD2U would direct NPPs to go back and change the medical record – after the encounter had occurred – to falsely show that more work was performed during the visit in order to support the highest level billing.
The post Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions appeared first on The Coding Network.
Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions
LOUISVILLE, KY – MD2U Holding Company, including its related companies and individually named owners (“Defendants”), have agreed to pay millions to resolve a government lawsuit alleging that they violated the federal False Claims Act by knowingly submitting false medical claims to Medicare and other government health care programs, altering records to support false claims, and providing services that were medically unnecessary U.S. Attorney John E. Kuhn, Jr. today announced….
MD2U also utilized an electronic medical records (EMR) system that permitted the NPPs to easily electronically cut, copy and paste medical notes from prior visits. The ability to migrate notes from visits that occurred weeks, months, or even years prior to the current patient encounter created the illusion that MD2U’s NPPs were performing a significant amount of work during their patient encounters when, in fact, they were not. If the documentation was deficient to bill the highest level code, MD2U would direct NPPs to go back and change the medical record – after the encounter had occurred – to falsely show that more work was performed during the visit in order to support the highest level billing.
The post Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions appeared first on The Coding Network.
Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions
LOUISVILLE, KY – MD2U Holding Company, including its related companies and individually named owners (“Defendants”), have agreed to pay millions to resolve a government lawsuit alleging that they violated the federal False Claims Act by knowingly submitting false medical claims to Medicare and other government health care programs, altering records to support false claims, and providing services that were medically unnecessary U.S. Attorney John E. Kuhn, Jr. today announced….
MD2U also utilized an electronic medical records (EMR) system that permitted the NPPs to easily electronically cut, copy and paste medical notes from prior visits. The ability to migrate notes from visits that occurred weeks, months, or even years prior to the current patient encounter created the illusion that MD2U’s NPPs were performing a significant amount of work during their patient encounters when, in fact, they were not. If the documentation was deficient to bill the highest level code, MD2U would direct NPPs to go back and change the medical record – after the encounter had occurred – to falsely show that more work was performed during the visit in order to support the highest level billing.
The post Louisville Based MD2U and Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions appeared first on The Coding Network.