Tag: Coding

SOUTH JORDAN, Utah – AdvancedMD, a software provider, has released its 2023 CPT/HCPCS Codebook. The resource includes the full list of updated CPT/HCPCS codes, identifying which medical codes have been added, revised and deleted by CMS. “Billing errors are an expensive mistake, equating to approximately $125 billion in uncollected money each year,” said Tim Constantino, vice president and head of product at AdvancedMD. “Not only do incorrect codes result in massive bill collection...

ATLANTA – The van Halem Group has announced that Dr. Doran Edwards has joined its team as a medical advisor. Edwards recently retired after three years with Palmetto GBA, where he was the medical director for the Pricing, Data Analysis and Coding contractor. He was also the medical director of the SADMERC, the predecessor to the PDAC from 2003-08. “Over the last few years, the van Halem Group has been working with manufacturers as they bring new products to market and need to navigate...

BALTIMORE, Md. - CMS will hold the annual Healthcare Common Procedure Coding System (HCPCS) Coding and Payment Determinations public meeting for DMEPOS on June 11-12, 2019. The meeting provides an opportunity to discuss coding and payment determinations for all new requests for revisions to the HCPCPS codes. Interested parties can make oral presentations or submit written comments. Registration information will be available at a later date.

COLUMBIA, S.C. - Palmetto GBA is taking over as the Pricing, Data Analysis and Coding (PDAC) contractor this month. The PDAC receives, evaluates and processes coding verification applications for DMEPOS; establishes, maintains and updates all coding verification decisions on the product classification list; provides coding guidance for manufacturers and suppliers on the proper use of HCPCS; maintains and publishes the NDC/HCPCS crosswalk and OACD pricing files; and conducts DMEPOS data analysis....

LENEXA, Kan. - Mediware Information Systems has acquired Fazzi Associates, a Northampton, Mass.-based provider of coding services to the home health and hospice market. Fazzi also provides consulting, training, benchmarking and research to more than 1,400 agencies across all 50 states and Washington, D.C. “The acquisition creates a unique alignment between two health care (companies)—one in innovative software, the other in outsourced services, consultation, and education,” Mediware...

WASHINGTON - CMS has taken away a Medicare beneficiary's “right to choose,” now that providers aren't allowed to use K0108 for titanium or heavy duty upgrades for manual wheelchairs, industry stakeholders say.In a joint article on Dec. 15, the DME MACs state that the codes for manual wheelchairs—K0001 through K0009—have always included the cost of these upgrades.“Suppliers billing for manual wheelchair bases must not include HCPCS code K0108 in addition to the base wheelchair...

LENEXA, Kan. - Two DME software product managers at Mediware Information Systems have been appointed to represent AAHomecare on the National Uniform Claims Committee for 2017. Rebecca Bowden and Kimberly Commito will participate in industry discussions related to maintaining the healthcare provider taxonomy code set, managing 1500 claims forms and monitoring legislative and regulatory changes that impact claims. NUCC comprises a diverse group of healthcare industry stakeholders representing providers,...

Editor's note: In the wake of new market pressures, upgrades, non-assigned claims and cash sales are taking center stage, says industry consultant Andrea Stark. The market has changed and your business should contemplate the suitability of these options, but they are not appropriate in all cases, she says. This is the first in a series of mini-articles that break down the top myths of filing non-assigned claims and leveraging upgrades and cash sales. Myth #1:  If an item is not coded, it does...

WASHINGTON - In highly anticipated clarifications on coding and coverage requirements for ventilators, the DME MACs have acknowledged that coverage for the product category isn't quite black and white.While the National Coverage Determination stipulates that vents are covered for neuromuscular diseases, thoracic restrictive diseases and chronic respiratory failure, the DME MACs acknowledge that these disease groups overlap conditions described in the local coverage determination for respiratory assist...

We are down to the wire on the ICD-10 transition deadline, and healthcare professionals everywhere are feeling the heat. MiraVista has developed some last minute advice to aid DME suppliers in their final steps: 1.      Focus on the highest and best use for your resources. If you are staring down a massive data set, don't work top to bottom. Parse out your data set to focus on active rentals, as these orders will create invoices on their own post-transition. 2.     ...