Patient Insurance Changes

by Cheryl Nash Open enrollment has started again and that means plan changes for a lot of patients. Medicare has continued to increase the number of Advantage products nationwide and the existing plans are competing for new enrollees. While keeping tabs is challenging for any practice, it poses even more potential issues for Phlebology. Some […]

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E&M Changes – What you need to know Jan 1.

by Cheryl Nash Below is a summary of the pertinent changes affecting practices with the new coding guidelines going into effect for 2021. Additional details can be found in the link appended to this article and readers are highly encouraged to look this over before implementing any of the new coding rules. The good news […]

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First Coast Service Options and Novitas LCD Changes

by AJ Riviezzo Effective 12/27/2020, both First Coast Service Options and Novitas will have new Local Coverage Determinations (policies)in place. There are some substantial changes to both the policies and some minor changes to what we reported on the original drafts. The largest change is to conservative therapy. If the patient is CEAP 2 or […]

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CPT Code 76970 is being Deleted

by AJ Riviezzo The CPT Code 76970 post-procedure ultrasound is being deleted effective the first of the new year. It was not being used much so out it went. The question is what to use in its place. The only code available now is 93971 limited diagnostic venous study of the lower leg(s). Because this […]

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Novitas Updates Part 2

by Cheryl Nash Last newsletter we brought you some of the highlights and changes from Novitas’ future LCD, going into effect on Dec. 27th. This letter will bring to your attention some of the language added to the coding article that is the companion document to the LCD. The coding article clearly outlines which codes […]

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OIG Exclusion List

by Cheryl Nash When we think of the term Compliance a lot of acronyms come to mind for the Medical Practice. OSHA, HIPAA, OCR, RAC, the list goes on and on, but one acronym, OIG, while familiar has a regulation a lot of new practices and even some more established ones are unaware of. This […]

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Patient Insurance Changes

by Dr. Stephen Daugherty A month back Dr. Santangelo sent out a query on the American Vein & Lymphatic Society’s Member’s Digest regarding why some providers are having difficulties with payers regarding board certification and holding hospital privileges. Dr. Daugherty was kind enough to send a rather extensive reply which we re-publish with his permission. […]

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ANTHEM CHANGES FOR 2020

by Cheryl Nash   A significant change in Anthem’s Policy SURG00037 is welcome news for providers this year. Language has been added allowing ablation of the AAGSV that was previously considered experimental.   The new policy has added AAGSV to the treatment parameters governing GSV and SSV, stating “Endoluminal radiofrequency ablation or endoluminal laser ablation, […]

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PHLEBECTOMY CODE CHANGES

by AJ Riviezzo   The largest coding/reimbursement change for phlebology practices is the decrease in phlebectomy reimbursement. The 10-20 stab phlebectomy has dropped 31.49 percent and the 20+ stab phlebectomy has dropped by 32.6 percent. With the National Average Reimbursement for the two codes now set at $457.26 and $534.85 this can represent a significant […]

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VARITHENA – PROVIDING SOME CLARITY

by AJ Riviezzo   We continue to get a few questions on when you can and cannot use the 36465 code for Varithena.  There is a bit of a disconnect between the FDA indication for Varithena:  “for the treatment of incompetent Great Saphenous Veins, accessory saphenous veins and visible varicosities of the great saphenous vein system above […]

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