ICD-10 RedThe ICD-10 transition is fraught with challenges for physician practices. As the code set increases dramatically, practices that are not fully prepared will likely experience an increase in denials, ballooning AR and reduced cash flow. Here are 3 warning signs your practice is not ready for ICD-10. 1. Impact Assessment?

Doctor with PatientIn an earlier post, we described CPT Category II codes and how they are used as tracking codes to facilitate data collection for the purposes of performance measurement. So how do you report these codes and what are the codes for these screenings?

United States CongressRep. Diane Black (R-TN) has introduced a new bill into the US House of Representatives that calls for an 18-month transition period following the implementation of ICD-10 on October 1. The bill, Increasing Clarity for Doctors by Transitioning Effectively Now Act  or the ICD-TEN Act (H.R.

ICD-10 RedTo provide the most up-to-date ICD-10 facts, CMS spoke with providers to identify common misconceptions about the transition.

CPT II Codes / category 2CPT Category II codes are tracking codes which facilitate data collection for the purposes of performance measurement. The tracking codes are adopted and reviewed by the Performance Measures Advisory Group (PMAG). The PMAG is made up of experts in performance measurement from organizations including the AMA, NCQA, CMS, AHRQ and JCAHO.

MedPACIn 2014, the Medicare Advantage (MA) program included 3,600 plan options, enrolled more than 15.8 million beneficiaries (30 percent of all beneficiaries), and paid MA plans about $159 billion to cover Part A and Part B services.

ICD-10 RedJust as we were all making peace with the fact that ICD-10 was a forgone conclusion, the House of Representatives introduces a bill to stop the October 1 implementation.

HumanaEffective June 22, 2015, Humana will make the following modifier changes to professional claims for their commercial fully insured (including HMOx and select self-funded members), Medicaid and Medicare Advantage HMO, PPO, and private fee-for-service members. However, not all of these products will necessarily be affected by each of the payment policies or modifier updates.

Blue Cross Blue ShieldEffective June 1, 2015, BCBSNJ will make changes to their reimbursement policies for modifiers 52, 53, 54, 55, 56, and 73. The purpose of this policy is to provide guidelines for the reimbursement of eligible services appropriately appended with modifiers for participating and non-participating professional providers.