Plus: Look for new nerve conduction study, facet joint injection codes. Although CMS has proposed halting payment for the consultation codes (99241-99255) in 2010, the AMA chose not to delete them, keeping them in the CPT manual for another year. Keep in…

Hint: Whether the fistula tract is established may decide whether code 31502 is warranted. For in-office tracheostomy tube changes, you won’t be able to report a separate service, but good news: you may be able to claim the cost of supplies.…

Plus: Senate lacks votes to change Medicare payment structure, but members vow to keep trying. CMS instructs MACs to suss out sham health care operations. A favorite tactic of some Medicare fraudsters is to set up ‘dummy’ storefront operations that have…

Don’t delay another day. If you haven’t changed your business arrangements to comply with new Oct. 1 Stark requirements affecting certain leasing and under-arrangement deals, now’s the time. In mid-October, Chicago attorney Kevin J. Ryan reported that’s he was still in the…

Don’t rely overly on the employment exception – or discount a competitor’s ability to stir up trouble. Covenant Medical Center in Waterloo, Iowa, recently agreed to fork over a hefty $4.5 million to settle a federal False Claims Act lawsuit involving alleged…

Pay attention to EOBs and keep talking to your MAC. You could be losing money to a computer glitch and not know it, experts say. If you don’t nip a computer glitch in the bud, you may be plagued with improper denials…

Question: An established patient reported to our practice with a cut in the vestibule of the mouth; it was bleeding moderately. The patient reported that he bit down on a lobster shell by mistake and cut the roof of his…

No maybes here – answer this question wrong and you will code your fracture claims incorrectly. When your physician performs fracture care for a patient, be ready to pounce on evidence of manipulation, as CPT often breaks fracture care codes along the…

Find out what could put you in jeopardy. If you think hospital physician compensation that exceeds fair market value can only trigger Stark concerns, beware. What is true: The anti-kickback law has a safe harbor for employment relationships that doesn’t require fair…

But don’t expect proposed changes to clear up your confusion. Figuring out which services Medicare will pay for is a toughie – but don’t think you’ll be able to look to the Centers for Medicare & Medicaid Services for guidance. In the HH…