More clarification of 2022 proposed fee schedule
New Medicare billing rights for physician assistantsBeginning Jan. 1, 2022, physician assistants (PAs) will be able to bill Medicare independently for their se…
Medicare publishes proposed rates for 2022
The Centers for Medicare and Medicaid Services (CMS) published its proposed 2022 Medicare Physician Fee Schedule on July 13, 2021. During 2021, because of a Co…
More E/M coding direction
The 2020 physician fee schedule finalized changes in evaluation and management (E/M) codes that became effective Jan. 1, 2021. It quickly became evident from p…
We clarify Evaluation and Management codes
This article has corrected information as of July 22, 2021.The 2020 physician fee schedule finalized changes in evaluation and management (E/M) codes that beca…
Need guidance on E/M codes based on time?
The 2020 physician fee schedule finalized changes in evaluation and management (“E/M”) codes that became effective Jan.1, 2021. It quickly became evident from …
Billing for Mid-level practitioners
Many commercial payers have begun to require that services performed by mid-level practitioners be billed under the National Provider Identifier (NPI) number …
AAP payments may begin in April
Early in the pandemic, the Centers for Medicare and Medicaid Services (CMS) offered Medicare providers loans, based on past Medicare billing, to help strugglin…
Summary of the American Rescue Plan
Last week, President Biden signed the $1.9 trillion American Rescue Plan (ARP), which provides new COVID-19 relief as well as establishes other policies. The D…
Can mid-level practitioners provide skin testing?
Many allergists are assisted by nurse practitioners (NPs) and/or physician assistants (PAs) in providing care in the office. The Advocacy Council frequently re…
2021 E/M coding and documentation rules
New rules for reporting outpatient office evaluation and management (E/M) services took effect Jan. 1. The coding and documentation revisions, adopted by the …
Good news for allergist payment
The Centers for Medicare and Medicaid Services (CMS) revised the 2021 Medicare Physician Fee Schedule (MPFS) rates and conversion factor (CF) following changes…
Billing for biological products
The Advocacy Council recently learned of a number of payer audits and recoupment requests related to Xolair billing - when a portion of the vial must be discar…
New prolonged service CPT code for 2021
Beginning in 2021, there will be a new code for reporting prolonged services together with an office visit. The new code, CPT Code 99417, replaces CPT Codes 99…
New Principal Care Management CPT Codes
The Centers for Medicare and Medicaid Services (CMS) has approved two new Principal Care Management (PCM) CPT codes for 2020 that may apply to allergists treat…
More on modifier -25 denials
In a recent Insider article, we discussed how some payers are denying claims for evaluation and management (E/M) services submitted on the same day as a proced…
Insurance denials for claims submitted with modifier -25
When physicians provide an evaluation and management (E/M) service on the same day as a procedure or test, they need to use modifier -25 to indicate that the E…
Food OIT is here – how do I get paid?
The Advocacy Council regularly receives queries from members on how to correctly code specific scenarios. Recently we received a request for assistance from a …
Correct coding for the administration of Xolair
The Advocacy Council regularly receives queries from members on how to correctly code specific scenarios. Recently we received a request for assistance from a …
Patient-centered Asthma Care Payment
ACAAI developed and submitted this APM for patient-centered asthma care.
Is it rush or cluster immunotherapy?
The Advocacy Council regularly receives queries from members on how to correctly code specific scenarios. Recently we received a request for assistance from a …
