Medicare’s Advanced Beneficiary Notice
This article was submitted to The LINK.
Medicare has very specific rules when it comes to their beneficiaries being made aware of their financial responsibility. I find that many physician staff members are confused about how and when the Advanced Beneficiary Notice (ABN) is to be used.
Medicare has identified certain codes that have ‘limited [...]
Medicare’s Smoking and Tobacco Use Cessation Benefit
This article was submitted to The LINK.
Over 400,000 smokers die each year from smoke related diseases. About 300,000 of those are Medicare patients age 65 and older. Research shows that about 10% of the total program costs for Medicare for 1997 were related to smoking. The U.S. Surgeon General has reported that quitting [...]
E/M Code 99211
This article appeared previously in The LINK.
Prior to 1998, 99211 was the most under used code in this country. This is no longer the case. Many physician offices are using this code commonly referred to as a ‘nurses visit’. Many insurance carriers are watching this code. Before entering this code on [...]
PQRI — Are You Cashing In?
This article appeared previously in The LINK.
Physician Quality Reporting Initiative (PQRI) is an incentive offered by Medicare to Medicare providers. PQRI will focus attention on quality of care. This program is paving the way for Pay for Performance.
Providers will use Category II codes, modifiers and temporary G-codes to report 74 unique [...]
-59 Modifier
This article appeared previously in The LINK.
CPT has some very specific rules for the use of modifier -59. This modifier is considered the modifier of last resort. You will typically use this modifier when no other modifier seems to fit.
Medicare and CPT have the same definition for this modifier. It is used [...]