In a recent release of 2018 benchmarks regarding modifiers 76, 77 and 79, the data of payment vs denials is staggering. For instance, a total of 159 codes reported with 91 and 249 codes that were reported using modifier 77 all had a 100% denial rate. Compared to the...

2021 brings us monumental changes to Evaluation and Management coding and reporting!  Notable changes will include: Deletion of CPT code 99201, new time reporting guidelines and modifications to criteria for medical decision-making.nThe new guidance also includes a...

As Risk Adjustment (RA) and Hierarchical Condition Category (HCC) coding continue to grow and become common practice it is important for not just coders, but also our clinicians to recognize its importance and the effect it has on reimbursement. Below is an example of...

During the State of the Union address, President Trump discussed the price transparency rule and slammed Medicare for all. Below are some of the main points President Trump made during the speech which included drug pricing plans, association health plans, and more....

In the January 23rd edition of the MLN Connects, CMS announced the release of a Comparative Billing Report (CBR) on Shoulder Arthroscopies for Medicare part B claims. This information can be vital for Orthopedic practices during the audit process. Data will be...

Recently, there has been a new healthcare scorecard that is evaluating the cost-saving policies in Colorado. Read the article below to see where Colorado ranks and what the state is doing to make healthcare more affordable to those living here!nnColorado is doing well...

The New Year always brings opportunities to grow and learn. While many find it difficult to be healthy in the workplace there are simple steps to take to achieve a healthier lifestyle. Below are six great tips on building healthy habits at work. Read the article below...

Medicare, the Affordable Care Act, and other issues are all hot topics being discussed in 2020.  Below is more information regarding some of the big topics that are in talks right now or are in the process of change. Read the article below for more information on some...

Vaping and E-cigarette use by young adults has grown over the past few years. While many are ignoring the effects of using these products, the CDC and CMS have released addendums regarding these products after the World Health Organization confirmed the side effects...

Anthem and Cigna have released updates regarding the reimbursement updates and changes. These changes will go into effect in March 2020. For more information on the updates and the changes that may affect you, read below!nnAnthem sent out a Notice of Material Change...

Last week, we briefly described the X modifier series and when to substitute these new modifiers. Below are a few scenarios from the NCCI policy manual you can refer to when using these modifiers.*nn The CCI bundle involving column 1 code 45385 (Flexible colonoscopy...

Welter Healthcare Partners is sharing the new 2020 CPT coding updates! Below you will find the new CPT codes that took effect on January 1st. Read below for more on these updates. Please note that this article is not an all-inclusive list of the updates. Be sure to...