Healthicity Blog

Q1: Can a physician and an NPP of the same specialty and the same group are both bill critical care code 99291 if documenting the critical time for the patient?

The Vermont hospital, Brattleboro Memorial, recently paid $1.6 million to the U.S. and State of Vermont to resolve allegations of false claims.

A few weeks ago, we presented a webinar on the impact of the 60-day overpayment rule since its release two years ago. We had so many questions at the end of the webinar, we couldn’t get to all of them.

In November of 2017, I attended the annual AMA CPT and RBRVS 2018 Symposium (Whew! What a mouthful!) in Chicago where I learned a ton about the new and revised codes for this year.

It’s been almost two years since CMS’ final rule on Reporting and Returning of Overpayments went into effect.

1. Virgil Dickson, Regulatory and Policy Reporter at Modern Healthcare

Most recent piece: Medicare Sticks with Mandatory Bundled-Pay Demo, But Tom Price Likely to Intervene.

On November 30th, the OIG posted its Semiannual Report to Congress. The report is a summary of the OIG’s activities from April 1, 2017 to September 30, 2017.

For those of you unfamiliar with coding and billing, modifier -59 is a two-digit numeric code modifier that can be appended to a CPT or HCPCS procedure code, for example, and will frequently bypass many payor edits.