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… Read More
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… Read More
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… Read More
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… Read More
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… Read More
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… Read More
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…. Read More
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… Read More
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… Read More
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… Read More