by Cheryl Nash Some of you may have seen the new NCCI edit that became effective on 10/01/2019 for CPT codes 36478 and 36470/36471. For those that haven’t, the edit has listed codes 36470/36471 as column 2 codes to 36478. In brief, that means they are considering sclero as inclusive to a laser ablation […]
END OF MBI TRANSITION PERIOD
by Cheryl Nash You may have received a message this week from Medicare MLN Matters that reads something like this: Special Edition – Tuesday, December 3, 2019 Provider Education Message: MBI Transition Ends This Month: Will You Be Paid On January 1? The 21 month transition period will end on December 31; […]
NEW CARDS, NEW YEAR
by AJ Riviezzo With the start of the new year, it is very important to ask your patients for a copy of their insurance card. It is not uncommon for the patient to have changed insurance carriers through their work. Obtaining the new card (or double checking the old one) will save a lot […]
THE PATIENT SAID…
by AJ Riviezzo We perform quite a number of chart audits for phlebology practices throughout the country. We are also asked to assist practices when they are targeted with an audit by Medicare, Blues or one of the commercial plans. As such, we are very aware of what is happening in regards to audits […]
CARE PLAN CONCERNS
by AJ Riviezzo As noted above, there are several other reasons besides conservative therapy requirements not being met which can cause an audit to go badly. A recent reason is the Care Plan. While the care plan may seem to be a straight forward result of good decision making by the practitioner, the audit […]
DON’T IGNORE PATIENT CREDIT BALANCES
by Cheryl Nash Credit balances are notoriously ignored in the daily operations of a medical office. With the priority placed on satisfying positive balances, the negative ones tend to be shoved to the side until a rainy day or the end of the year rolls around, so this tips to manage finances can be very […]
UNITED HEALTHCARE POLICY CHANGES
by AJ Riviezzo United Healthcare (UHC) came out with a new policy dated September 1, 2019, Policy Number 2019T0447Y. The policy still allows the treatment of GSV that are at least 5.5mm and SSV that are 5.0mm along with perforators underlying an ulcer and 3.5mm in size. Other criteria must also be met. Of […]
2020 PROPOSED MEDICARE REIMBURSEMENT
by AJ Riviezzo Medicare just released their proposed rules. While there is a lot of information to unpack in the documents, there are some notable elements that will impact the phlebology community. First and foremost is the change in reimbursement for some codes. In an effort to bring costs in line with reality, […]
Non-Thermal Technologies and Medicare
by AJ Riviezzo The various Medicare administrators (MACs) have been allowing the non-thermal technologies (ClariVein, Varithena and VenaSeal) to be paid (First Coast Service Options covering Florida/Puerto Rico does not cover ClariVein unfortunately). However, the language in the various Local Coverage Determinations by most of the MACs has not been updated. This leads to […]
VARITHENA USE AND CODING
by Cheryl Nash The question of how to bill for Non-Compounded Foam, commonly known as Varithena, has caused some confusion in phlebology circles, so we thought we would clarify some of the most commonly asked questions presented to APFS. Q. We have been told we can use Varithena to treat tributaries, is this […]