Medicare

The Centers for Medicare & Medicaid Services (CMS) added new 2022 Quality Payment Program (QPP) performance information for doctors, clinicians, groups, virtual groups, and Accountable Care Organizations (ACOs) to clinician and group profile pages on the Medicare.gov compare tool and in the Provider Data Catalog (PDC).

“Medicare DMERC B jurisdiction has stopped abruptly allowing and paying for L3010 using RT KX and LT KX. I cannot find any information of new modifiers or other info needed. Any suggestions?"

“After watching some E/M presentations, it was suggested that hospital consultations should be billed with CPT 99252-CPT 99255. When we billed these codes, our EMR system and our clearing house rejected the codes. They are saying effective 1/1/2010, CMS has announced that they will reject these codes. Are we billing the right codes?”

If a patient that has Traditional Medicare and a secondary coinsurance, when, if ever, is it appropriate or is it payable to bill for a consultation code such as CPT 99243 or CPT 99244?

If a Medicare patient has a secondary, supplemental insurance that our practice does not participate with, how should this be handled?

Can you please explain the appeals process for Medicare?

The JZ modifier will show Medicare if providers are using pharmaceuticals efficiently by identifying the amount of unused and discarded drugs from single-dose containers or single-use packages. One way to remember the correct use of these drugs is waste vs zero-waste.

REGCLR7 - Use of Ankle Foot Orthotics to Improve Patient Function

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Medicare Requirements for Home Health Care