• Senate Repeals SGR in Landslide Vote Image

    articleApr 15, 2015

    Senate Repeals SGR in Landslide Vote

    Well, folks, the fix is in—the fix for the sustainable growth rate (SGR), that is. In a 92 to 8 vote, the Senate approved the SGR repeal bill, called HR2. In addition to an SGR repeal, the bill also officially extends the therapy cap exceptions process until December 31, 2017. This result is better than no therapy cap exceptions process at all; however, it’s disappointing to know that we came so close to achieving a full repeal …

  • Brace Yourself: Decreased Payments Might be Coming Image

    articleApr 14, 2015

    Brace Yourself: Decreased Payments Might be Coming

    As we warned at the end of last month , the times they are a-changin’. You’re likely well aware of the legislation that could do away with the Sustainable Growth Rate (SGR)—and extend the therapy cap for another two years. We had hoped to have better news for you at this point, but we’re still hanging tight while the Senate sings their own off-key version of Wilson Phillips’ “Hold On.” It’s April 14, 2015. That means the …

  • The Claim Game: How to Manage Overpayment Image

    articleApr 9, 2015

    The Claim Game: How to Manage Overpayment

    If you’ve recently discovered that a patient or insurance company overpaid you for services rendered, you might be tempted to consider it “free money.” It’s like you’re playing Medicare Monopoly, and you just pulled a Community Chest card that reads: “Insurance error in your favor. Collect claim overpayment.” However, overpayments give you an inflated appraisal of your total revenue and might even encourage embezzlement —both of which can wreak havoc on your balance sheet. Worse yet, if …

  • The PT’s 2015 ICD-10 Checklist  Image

    webinarFeb 24, 2015

    The PT’s 2015 ICD-10 Checklist

    The ICD-10 switch is upon us—October 1, 2015, to be exact—and you only have about seven months to finalize all of your clinic’s preparations. Feel your brow beading with stress sweat? Instead of fretting, tune in to this must-watch webinar. Hosts Heidi Jannenga and Mike Manheimer will outline everything you and your practice need to do to be ICD-10-ready before the clock runs out. In this session, you’ll learn how to: Assess current clinic diagnosis coding processes …

  • Beware of ICD-10 Shortcuts: The Case Against One-to-One Crosswalking Image

    articleFeb 24, 2015

    Beware of ICD-10 Shortcuts: The Case Against One-to-One Crosswalking

    ICD-10 is inherently more sophisticated and specific than ICD-9, but that doesn’t necessarily mean it’s more complicated. So, why are healthcare professionals pulling their hair out over the mandatory transition to these new codes? Because learning ICD-10 is like learning a new language. If we were going into this with a clean slate–like a newborn babe—perhaps it wouldn’t be so tough to learn the language. Unfortunately, though, the US healthcare industry has relied on ICD-9 codes for …

  • 50 Shades of ICD-10 Image

    articleFeb 19, 2015

    50 Shades of ICD-10

    While ICD-10 may not make you hot, it probably gets you pretty bothered. Finding an ICD-10 code that’s a perfect match for a particular ICD-9 code is like trying to find a shade of paint that’s the exact same color as your new gray throw pillows. You might assume you can simply tell your friendly hardware store associate you’d like a can of gray paint for your living room, and boom—all done. Easy peasy. But when you …

  • History of ICD-10 Image

    articleFeb 17, 2015

    History of ICD-10

    If you haven’t heard of ICD-10 by now, you’ve probably been living under a rock . Though CMS has talked about the impending implementation of ICD-10 like a boy crying “Wolf!, ” the days of false alarms are over—at least that’s what the experts are saying . That’s right: it’s finally happening, folks. And the mandatory transition to the new diagnosis code set will be here before we know it (even if it is 20 years late). …

  • What's the Deal with the New Modifiers? Image

    articleFeb 10, 2015

    What's the Deal with the New Modifiers?

    In addition to unleashing all the 2015 PQRS changes , the Centers for Medicare and Medicaid Services (CMS) decided to throw us another curveball by introducing the following four HCPCS modifiers —called the X{EPSU} modifiers—to “define specific subsets” of the 59 modifier. XE Separate Encounter, A Service That Is Distinct Because It Occurred During A Separate Encounter XS Separate Structure, A Service That Is Distinct Because It Was Performed On A Separate Organ/Structure XP Separate Practitioner, A …

  • Have You Considered These 3 ICD-10 To-Dos? Image

    articleFeb 3, 2015

    Have You Considered These 3 ICD-10 To-Dos?

    “How do you eat an elephant? One bite at a time.” That’s how the age-old adage goes, but aside from it being a totally messed-up saying—why are we eating elephants?—it also falls totally flat in my book. When we talk about eating an elephant, it implies that we’re devouring something. In reality, though, with any significant or substantial endeavor, we’re actually trying to triumph. And I’m not sure if anyone would count gorging on a pachyderm as …

  • On a Scale of 1 to ICD-10, how Prepared are You? Image

    articleFeb 2, 2015

    On a Scale of 1 to ICD-10, how Prepared are You?

    Like yet another season of Survivor , ICD-10 is inevitable, and while the Department of Health and Human Services (HHS) won’t drop you on a remote, hostile island when the ICD-10 switch happens, the new coding terrain may be just as unfamiliar, uncomfortable, and treacherous—unless you’re ready. Here’s how to win at ICD-10 (no shelter-building or fire-making required). Hit the Books Switching from a code set with roughly 13, 000 codes to one with about 68, 000 …

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