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04/13/15

Billing For Ice Massage and Fluidotherapy

Two questions I frequently receive is how do I bill for ice massage and how do I bill for fluidotherapy? Here are the answers. According to the August 2006 edition of CPT Assistant, the appropriate CPT code to bill for ice massage is

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04/06/15

Examples of When to Use Modifier XU

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such as a use to identify different encounters, different anatomic sites, and distinct services. Usage to identify a separate encounter is infrequent and usually correct; usage to define a separate anatomic site is less common and problematic; usage to define a distinct service is common and

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03/31/15

Therapy Cap Exception Process Has Expired

On March 26, 2015, the United States House of Representatives passed H.R. 2, the Medicare Access and CHIP Reauthorization Act, by a vote of 392-37. This legislation permanently repeals the flawed sustainable growth rate (SGR) formula, thereby avoiding the scheduled 21.2% reduction that is to go into effect on April 1, 2015 and provides a 0.5% increase in payments under the Medicare Physician Fee Schedule beginning this year and continuing through 2019. This legislation also extends the therapy cap exception process for outpatient therapy services through December 31, 2017. This legislation was then sent to the Senate; however, the Senate

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03/30/15

Examples When to Use Modifier XS

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such as a use to identify different encounters, different anatomic sites, and distinct services. Usage to identify a separate encounter is infrequent and usually correct; usage to define a separate anatomic site is less common and problematic; usage to define a distinct service is common and

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03/23/15

Example When to Use Modifier XP

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such as a use to identify different encounters, different anatomic sites, and distinct services. Usage to identify a separate encounter is infrequent and usually correct; usage to define a separate anatomic site is less common and problematic; usage to define a distinct service is common and

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03/16/15

Examples of When to Use Modifier XE

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such as a use to identify different encounters, different anatomic sites, and distinct services. Usage to identify a separate encounter is infrequent and usually correct; usage to define a separate anatomic site is less common and problematic; usage to define a distinct service is common and

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03/13/15

CMS Updates Several Fact Sheets

The Centers for Medicare and Medicaid Services has updated several fact sheets including Medicare Physician Fee Schedule, Medicare Fraud and Abuse, Medicare Enrollment Guidelines for Ordering/Referring Physicians, and Medicare Compliance Products. To access each Fact Sheet, Gold Members log into your account and if not a Gold Member, join now and then click on the appropriate link below

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03/09/15

OIG Recommends CMS Pay SNF Rates for CAH Swing Beds

The Office of Inspector General has released a report recommending that the Centers for Medicare and Medicaid Services (CMS) seek legislation to adjust Critical Access Hospital (CAH) swing-bed reimbursement rates to the lower SNF PPS rates paid for similar services at alternative facilities. CMS agreed with our finding that CAHs’ swing-bed utilization has increased but disagreed with our recommendation because of concerns with our findings on the availability of skilled nursing services at nearby alternative facilities and our calculation of savings. To read the full report, click HERE.

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