01/29/20 | New Drug Delivery Codes 20700-20705
 

Stop using 11981-11983 as of Jan 1st 2020- Use the new drug delivery codes 20700-20705 --

New Drug Delivery Codes 20700-20705
 
04/04/19 | Watch your "stem cell" wording - On going FBI investigations
 

For those offices that are using the wording 'stem cells' or charging patients for these services you need to be aware of the FBI ongoing investigations.

Watch your
 
02/28/19 | Great article on the issues with 63047 and 22633 and 22630
 

Find out about the issues between 22633/22630 and 63047 and get the history of these codes.  Great information you can use for your private payer appeals.

Great article on the issues with 63047 and 22633 and 22630
 
01/02/19 | Accessing Newsletters
 

How to get newsletters

Accessing Newsletters
 
01/02/19 | Calendar events
 

Calendar events

Calendar events
 
09/26/18 | Scam audio flyer Fionexia - please don't sign up
 

It has come to my attention that there is a flyer (from Fionexia) that is going out from a company that is fraudualent and stating I am doing an audio for them.  Please do not sign up it is a scam.  The audio they are advertising was done for AudioEducator.com. It appears if you pay for it you may not get anything for your pay!!!

Scam audio flyer Fionexia - please don't sign up
 
08/11/18 | Margie Vaught Newsletters
 

Now you can access and download the newsletters directly from this site. 

Margie Vaught Newsletters
 
07/20/18 | 2019 Proposed Fee schedule released
 

Proposed 2019 Fee Schedule is out – hang on to your seats…

CMS released the 12th of July the proposed changed for the physician fee schedule for 2019 (https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-07-12.html).

2019 Proposed Fee schedule released
 
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If you billed for any therapy services as of Jan 2013 and you got an EOM from Medicare stating "beneficiary liability (Group Code “PR”)" it was processed wrong and you will need to refund ASAP to the patient ---
Here is what was recently released...

"Change to Payment Liability for Therapy Cap Denials

Section 603(c) of the American Taxpayer Relief Act of 2012 (ATRA) changed the payment liability for denials resulting from the outpatient therapy caps from beneficiaries to providers effective January 1, 2013. Medicare systems were not updated in time to accurately represent this change on provider remittance advices (RAs). Medicare contractors may have already processed therapy cap denials for services provided in 2013. These denials incorrectly report on RAs beneficiary liability (Group Code “PR”) when liability legally rests with the provider (Group Code “CO”).

Due to differing claims processing system constraints, this inaccurate RA reporting will be corrected beginning on different dates for different claim formats. For institutional claims, the correct liability will be reported beginning on June 24, 2013. For professional claims, the correct liability will be reported beginning on January 1, 2014.

Since Medicare’s payment amount for these claims is correct, Medicare Administrative Contractors will not adjust claims processed before these dates to correct the Group Code. To do so could create disruptions for providers’ accounts receivable. Instead, therapy providers should review any therapy cap denials for dates of service on or after January 1, 2013, to determine whether any payments have been collected from beneficiaries. Providers should refund any beneficiary payments they find for these services. Additionally, providers should cease to collect payments for therapy cap denials unless the beneficiary was appropriately notified via an Advanced Beneficiary Notice of Noncoverage (ABN)."