Q: A workers' compensation carrier (U.S. Department of Labor) has refused payment on our standard microdiscectomy code, saying that, per Medicare's standards, this is not considered a procedure that Medicare approves payment on in a medical facility such as an…
ASC Coding, Billing & Collections
1. Control of bleeding not separately billable. The control of bleeding is included in biopsy (and most other) endoscopic procedures, and is not separately billable unless the patient comes into the facility with a GI bleed, which is the reason…
The final Medicare Conditions for Coverage were published Oct. 30, 2008, with an effective date of May 18, 2009. This is the first major change to the Conditions since they were initially adopted in 1982 and therefore will impact all…
CIGNA has agreed to end its relationship with the Ingenix database and pay $10 million towards the development of a new database, according to a news release from the N.Y. Office of the Attorney General.
As "out of pocket" expenses continue to climb for patients, providers must do everything they can to make it easier for patients to pay their bills. Those medical facilities that succeed will reap the benefits of improved cash flow and…
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N.Y. Attorney General Andrew Cuomo announced a settlement with the nation’s largest health insurer, Indianapolis-based Wellpoint over allegations that the insurer manipulated reimbursement rates, according to news releases.
Medicare has tentatively decided that it will not cover virtual colonscopies, citing inadequate evidence that it is an effective test for colorectal cancer, according to an announcement on the CMS Web site and a report in the New York Times.
The number of uninsured Americans will rise from 45 million in 2009 to 54 million in 2019, according to Senate testimony by Congressional Budget Office Director Douglas Elmendorf.
Medical device maker NeuroMetrix has agreed to pay $3.7 million to settle federal allegations that it gave kickbacks to physicians, according to news releases from the U.S. Attorney's Office and NeuroMetrix.
The American Medical Association (AMA), along with several state medical associations, have filed two separate class-action lawsuits against Aetna Health and CIGNA Corp. alleging that the companies underpaid physicians using flawed billing practices, according to an AMA news release.