Appropriate Use Criteria (AUC) Program Implementation – What’s Happening in 2021?

Posted Posted in Insights, Radiology

The release of the Medicare Physician Fee Schedule (MPFS) CY2021 proposed rule on August 3rd contained a lot of information for radiology providers to digest (a proposed 10.61% reduction to the conversion factor for 2021!), but there was also a noticeable absence in the proposed rule – any discussion of the Appropriate Use Criteria (AUC)/Clinical […]

Pelvic Angiography – When is it Appropriate to Assign 75736?

Posted Posted in Insights, Interventional Radiology

Pelvic angiography – it’s a term we see in reports and there’s a CPT® code specifically describing it, so why is this code so frequently mis-used? The answer to that involves understand what the definition of true pelvic angiography entails and the key terms to look for in documentation to support it. Selective (True) Pelvic […]

Molecular Testing – Why Is Reimbursement Lacking?

Posted Posted in Laboratory

Molecular diagnostic assays are one of the fastest growing segments for clinical diagnostics. Advancements in testing capabilities allows for rapid determination by simultaneously assessing multiple genes, which for some patients will have life changing effects, by identification of low prevalence inherited and environmentally induced diseases, syndromes and conditions. The advancements in testing capabilities are exciting […]

Biliary IR Coding – 5 Common Mistakes

Posted Posted in Insights, Interventional Radiology

With most bundled code sets, it’s the small details that make all the difference. Biliary procedures are much the same. The code descriptions look similar but contain subtle variations that require a good understanding of the full, long description of each code. However, code descriptions don’t always provide all the information needed for correct application […]

Ventilation Assist and Management: Clarifying Common Questions

Posted Posted in Insights, Respiratory Therapy

During this public health emergency, a lot of talk is centered around ventilators and the critical role this equipment plays in treating patients with COVID-19. Granted, in a time of crisis where hospitals are (or have the potential to be) overwhelmed with patients requiring lifesaving care, documentation and compliance aren’t at the top of the […]

COVID-19 Codes: The Ones You Need to Know

Posted Posted in Insights, Laboratory, Uncategorized

CMS released multiple reporting codes for COVID-19 for laboratory services. We created this guide to help you understand the latest information and implications for the COVID-19 codes currently available. Fill out the form to download the article.  COVID-19 Laboratory Codes Name* First Last Email* Enter Email Confirm Email Phone* Job Title* Facility* State* AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of […]

Update: New CPT® Category I Codes Released for SARS-CoV-2 (Coronavirus Disease [COVID-19]) Antibody Testing

Posted Posted in Insights, Laboratory

Continuing their quick response as the COVID-19 pandemic evolves, the American Medical Association (AMA) held another special meeting of the CPT® Editorial Panel to address the immediate need for codes to report and track antibody testing specifically for SARS-CoV-2 (the virus that causes the disease COVID-19). Effective April 10, 2020, the AMA has approved the […]

Specimen Collection for COVID-19 Testing – Payment Updates

Posted Posted in Insights, Laboratory

Under the recently released Interim Final Rule from the Centers for Medicare and Medicaid Services (CMS), payment rules for specimen collection are changing for the public health emergency (PHE) caused by the COVID-19 pandemic. With this change, CMS will provide payment to independent laboratories, under certain circumstances, for specimen collection from home-bound beneficiaries or inpatients […]