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 […]

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ANTHEM PRE-PAYMENT REVIEW

by Cheryl Nash   It has come to our attention that Anthem is initiating pre-payment reviews for frequently billed Varicose Vein CPT codes including 36470 and 36471 along with ablative codes 36465-36479. A conversation with a reviewer revealed this is in their nationwide markets and many providers may be affected.   It was advised that […]

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BREAKING NEWS REGARDING NOVITAS

by AJ Riviezzo   Novitas had come out with a new Local Coverage Determination outlining some changes in sclerotherapy usage, but more importantly they denied coverage for all of the new non-thermal technologies. The implementation date was supposed to be March 21st. For whatever reason it is now back to a Pending status for implementation. […]

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NEW MEDICARE AUDIT CONSIDERATIONS

by Cheryl Nash   Recently a client alerted me to a Medicare audit they received. Aside from the usual pull list for medical records, an interesting additional request caught our attention. On this occasion Medicare also asked for “a copy of licenses and/or certifications for all personnel documenting in the beneficiary’s chart or performing services.” […]

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ARTERIAL STUDIES

by Cheryl Nash   If your practice is performing peripheral arterial studies, the guidelines for doing so are very stringent as compared to venous studies. The list defining medical necessity for arterial scans is lengthy and should be read in its entirety for any physician currently doing or thinking about adding these services to their […]

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NON-THERMAL ABLATIONS AND THE PAYERS

I have had a number of conversations with our clients and others regarding non-thermal ablations. Unfortunately, the majority of these conversations are in regards to difficulties in obtaining reimbursement. Here is our rather conservative approach to these newer technologies and newer codes.   Review the Policy – This is the safest way in ensuring proper […]

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DEDUCTIBLE SEASON

It is here again. The slowing of the number of patients who wish to receive treatment because of their new deductible. There are three different paths we see practices take in collecting patient deductibles and co-insurance. I’ll review the three paths and then offer our recommendation.   Dolittle Approach: The practice basically assumes that the […]

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HIPAA CONSIDERATIONS AND TECHNOLOGY

  Over the course of the year, we have seen new ways to violate HIPAA as well as some old standards. Noted below are a few HIPAA issues for your consideration.   Office Laptop: One practice kept a lot of patient files and information on a laptop’s hard drive. The laptop was stolen. Now, the […]

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MEDICARE 2019 FINAL RATES

The Centers for Medicare and Medicaid Services (CMS) just posted the new Medicare fee schedule for 2019.  There are a number of changes that will impact the phlebology physician.  Please keep in mind that any allowed amounts you receive will be different (up or down depending on geographic area)from the ‘national average’ rate listed below. […]

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PICK ME, PICK ME!

Perhaps you do not really want to be picked as we are discussing why Medicare or perhaps one of the Blues may pick you to do a preliminary or more in depth audit. There are a variety of reasons you may be audited, but the top 7 reasons that are not due to external issues […]

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