What It Is and What a Practice Needs to Know The Comprehensive Error Rate Testing (CERT) program is a crucial component of the Medicare program that helps ensure the government is paying only for the services and care that beneficiaries actually receive. The program is designed to identify improper

What Are They, and What Do We Do With Them? CMS (Centers for Medicare and Medicaid) is always implementing various programs and initiatives aimed at reducing fraud, waste, and abuse. One such initiative is Comparative Billing Reports (CBRs). In this article, an overview of CBRs, their purpose, and how

The pandemic and the public health emergency (PHE) it brought along with it, have changed how health care is delivered.  Commercial payors have been more amenable to paying for telehealth services in prior years.  Due to the pandemic, CMS decided to relax its guidelines on telehealth acceptance and payment. 

CMS issued a final rule on the Medicare Physician Fee Schedule and some other policies that are slated to start on or after January 1, 2021.  The 1,994 page document has a lot of information on many different policies, so a few important ones will be highlighted here, but

The last big change for Evaluation and Management (E/M) coding was in 2010 when Medicare stopped accepting consultations. Not since 1997 have the guidelines gone through such a big adjustment. Due to the pandemic, though, many practices are not prepared for this upcoming change. This article will look at an

Question: One point of clarification I’ve wondered about. What defines the chronicity of the condition? Is it if it’s lasted more than one year already for the patient or is it if we know that it’s going to last more than a year even if it’s only lasted a few

Question: When I am performing a shave biopsy, I append diagnosis code D48.5 to the service.  My coder is telling me that it is incorrect, and I should use D49.2 instead.  Who is correct?  Answer: The coder is correct on this one.  D48.5 is Neoplasm of Uncertain Behavior of