Category Archives: Coding & Billing
Medicare Billing for Seasonal Flu Vaccines
As you know, Medicare began covering annual influenza immunizations in 1993 for all Medicare beneficiaries. Medicare covers both the costs of the vaccine and its administration by recognized providers. There is no coinsurance or co-payment applied to this benefit, and … Read Full Post
How should I prepare for ICD-10?
From time to time, we hear about consultants scaring the daylights out of providers with horror stories about the transition to ICD-10. We disagree with that approach, although it’s important to have a healthy respect for any system that – … Read Full Post
What exactly is ICD-10?
ICD-10-CM (based on the International Classification of Diseases, 10th edition, Clinical Modification) is a standard set of codes used for conveying a patient’s clinical profile, if you will. Defined codes are used primarily to facilitate the gathering of data, its … Read Full Post
New CMS ABN Booklet Available
CMS has revised a booklet that explains the Advance Beneficiary Notice of Noncoverage(ABN) Form. An ABN is a standardized form that health care providers must give Medicare beneficiary when the provider believes that Medicare may not pay for an item … Read Full Post
Why is my Risk Score so low when my patients are so sick?
A risk score is a numeric representation of the health status of your patients based on factors developed by the Centers for Medicare and Medicaid Services (CMS). Each patient has a risk score and your practice has one too. The … Read Full Post
How does provider reimbursement work?
There are two common methods of reimbursing physicians: Fee-for- service (FFS) and capitation. There are also two major code categories in use by most primary care physicians: ICD-9-CM codes and CPT-4 & HCPCS codes. ICD-9-CM codes (soon to be replaced … Read Full Post