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Learn 2 New CMS Appeal Thresholds Before Filing

We’ve got a handy chart to help you keep everything straight, plus quick links to all the rules & forms.
The time has come yet again to update your appeals know-how. CMS announced several changes to the appeals process effective Aug. 3, 2009, in Transmittal 1762.
Focus on Higher Dollar Amounts
CMS has changed the dollar amount in […]

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Skull Biopsy, No Burr Hole: 61500 or 61563?

Question: Our surgeon biopsied a lesion from the skull, but did not perform a craniectomy or create a burr hole for the procedure; he made an incision over the lesion and obtained the biopsy. How should I code this?
Answer: Your best option is 61500 (Craniectomy; with excision of tumor or other bone lesion of skull) […]

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Clinch E/M Plus Chemo Pay Using These CMS Guidelines

Here’s why 99211 flashes a bright red ‘audit me’ sign at payers.
At roughly $60 a pop, missing just one 99213 service a day could cost your practice more than $15,000 a year. Use these official rules from Medicare to be sure you know when you should —and shouldn’t — add an E/M code to your therapeutic drug and […]

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  1. Do I Use a Chemo Code for Zevalin Therapy?Question: When I looked up Zevalin, I found out it’s…
  2. CODING CHALLENGE: Is V58.11 Right for Patient Not on Chemo? Question: When you use a chemo admin code for…
  3. Prevent Shot, Hydration, IVIG Code Denials With This 3-Step ChecklistIf you miss this CPT 2009 change, you’ll lose $21…
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