CPT code 95165 – What’s a dose for Medicare billing?
Medicare defines a dose, for billing purposes only, as 1cc of extract and does not cover dilutions. Medicare reimbursement is based on this definition.
Coding Conundrum – E/M plus Testing
Recently we received a query from a member about coding an oral challenge and an office visit on the same day.
2024 G2211 Add-On Code
If you bill G2211, it is important that you document the reason for billing the code. Supporting documentation must demonstrate two elements.
2024 – Use of JZ and JW Modifiers
This article provides a high-level overview of the requirements for using the JW and JZ modifier. Learn more...
2024 RVUs impact allergy
Allergists are expected to experience a -1.9% reimbursement impact due to the lower 2024 conversion factor (which takes into account the 1.25% legislative incr…
Site-Neutral Payments
Lawmakers have begun to focus on one option: expanding site-neutral payments for services in off-campus Hospital Outpatient Departments.
Value-Based Care Task Force identifies opportunities for allergists
This expert group is now looking at a variety of value-based care arrangements that can benefit allergists
2024 CPT and ICD-10 Coding Changes
Revisions to the 2024 CPT code set clarify the reporting of evaluation and management (E/M) services to decrease burden of documentation
2022 MIPS Performance Feedback
The Advocacy Council strongly encourages you to view this information as soon as possible for two reasons.
EFT fees burden physician offices
For years, physicians have faced reduced payments from commercial health plans using virtual credit cards and third-party electronic payment vendors for standa…
2024 Proposed Medicare Physician Fee Schedule – impact on allergy practices
This article summarizes key proposals concerning the Medicare Physician Fee Schedule (MPFS) that would impact allergy practices.
2024 MIPS Proposed Changes
This article provides a summary of key proposals and changes to the traditional MIPS program that will impact allergists.
AMA’s Vital Physician Practice Expense Study will collect data on physician practice expenses
A new national AMA study, supported by the College and 173 health care organizations, to collect data on physician practice expenses.
2023 diagnosis coding specificity
Since this rule was implemented, we have received very few reports of audits denying claims using unspecified codes - until recently
New JZ modifier implementation begins July 1
Medicare will require the use of the new JZ modifier for single-dose containers when there are no discarded amounts of a drug/biologic.
Medical Debt Collection
Good faith estimates and medical debt collection will likely impact your practice and your patients in 2023.
Confirming diagnoses
The Advocacy Council regularly receives queries from members on how to correctly code. Many are common issues, including for coding unconfirmed diagnoses.
Expiration of COVID HIPAA Enforcement Discretion
To help providers come into compliance with the HIPAA Rules on telehealth, OCR is providing a 90-day transition period ending August 9, 2023.
2023 MedPAC report encourages physician payment reform
These reports make nonbinding recommendations to Congress and also assess various aspects of Medicare payment policy.
AMA Medicare specialty impact analysis
A/I was one of 16 specialty groups to experience a 2% cut in Medicare payments as a result of the 2023 Medicare PFS final rule and the CAA.
