Records audits are on the rise
Members have advised the Advocacy Council of an issue that seems to be spreading nationwide – audits by insurers of claims submitted by allergy practices for r…
Medical debt collection landscape to change
The Biden Administration recently announced an initiative to evaluate how providers’ billing practices impact access and affordability of care and the accrual …
Administering drugs/biologics in physicians’ offices
Claims for drugs/biologics should be billed using the HCPCS/CPT code that most accurately describes the drug. Information in this article concerns drug adminis…
CMS guidance prohibits excessive EFT fees by payment vendors
The CMS National Standards Group (NSG) published guidance clarifying that health plans, as well as their payment vendors, must provide payments to providers us…
New guidance on Good Faith estimates
Last week the Centers for Medicare and Medicaid Services (CMS) published new guidance that provides important clarifications about the content of Good Faith Es…
Are consultation codes obsolete?
In 2010 the Centers for Medicare and Medicaid Services stopped paying for consultation codes. While it continued to recognize the concept of consults, it paid …
Advocacy Council pushes to extend sequester moratorium
Since 2020, the 2% Medicare sequester moratorium has been in effect – and we are urging Congress to continue it through the end of the public health emergency …
Dealing with Modifier -25 denials for office visits and skin testing
The Advocacy Council regularly receives queries from members on how to correctly code specific scenarios. Recently we received a request for coding an office v…
Telehealth services: Can you provide them for your out-of-state patients?
As the public health emergency (PHE) continues and issues related to COVID-19 change quickly, you may be wondering whether you can continue to provide teleheal…
CPT Codes for testing to local anesthetics
The Advocacy Council regularly receives queries from members on how to correctly code specific scenarios. Recently we received a request for coding a local ane…
… results in Billing, Coding & Payments.
