June 27, 2014, 9:00 AM PDT / 12:00 PM EDT

Not sure when to apply modifier 59? Wondering why you have to use the KX modifier? Let’s face it: modifiers can get pretty confusing. There are a lot of rules to keep straight—and most of them are anything but cut-and-dried. That’s why we focused this month’s webinar on all things modifiers. WebPT founder Heidi Jannenga, PT, teamed up with compliance expert Tom Ambury to host an open forum. They devoted the first half of the webinar to explaining the ins and outs of modifiers, and the second half is a live Q&A.

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    articleFeb 10, 2015 | 3 min. read

    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 …

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    It’s a mad, mad, mad, mad Medicare world, and unfortunately, just about every regulation requires a modifier. If you apply the wrong modifier—or forget one entirely—then your clinic suffers decreased payments or flat-out denials. Even worse, if you amass enough modifier mistakes, you make your practice vulnerable to an audit. Worried you’re miserable at modifiers or want confirmation that you’re actually a modifier master? Take our 10-question quiz below to test your modifier know-how.    

  • Should PTs, OTs, and SLPs use the New X Modifiers? Image

    articleDec 7, 2016 | 4 min. read

    Should PTs, OTs, and SLPs use the New X Modifiers?

    In the world of rehab therapy, determining—and billing—the right codes and modifiers can be one of your biggest challenges. That’s certainly true when it comes to properly using modifier 59—and the blog posts we’ve previously written on this topic have generated a lot of reader questions. To complicate matters even more, back in January 2015, CMS rolled out four new HCPCS modifiers for healthcare practitioners to use in lieu of modifier 59—thus giving providers a way to …

  • Trick or Treat: A Creepy-Crawly Compliance Quiz Image

    articleOct 31, 2016 | 1 min. read

    Trick or Treat: A Creepy-Crawly Compliance Quiz

    Medicare compliance can be tricky—if not downright terrifying (sounds an awful lot like our favorite creepy-crawly holiday, Halloween). So when it comes to compliance, do you scare easily? Or, do you know the mean Medicare streets like the back of your hand? Take this frightening Medicare compliance quiz to find out whether your compliance basket is fraught with compliance tricks or filled to the brim with satisfying treats. Oh! And one last thing: while the scenarios and …

  • Technical Diligence: The Key to Stopping Claim Denials Dead in their Tracks Image

    articleJul 9, 2015 | 5 min. read

    Technical Diligence: The Key to Stopping Claim Denials Dead in their Tracks

    Hello, readers. Over the past several weeks, I’ve enjoyed answering a number of your questions regarding billing for PT services, so I’m excited to address the topic right here on the WebPT Blog. On June 19, 2015, the Office of the Inspector General (OIG) released a report involving an outpatient private practice physical therapy provider. In case you weren’t aware, the OIG—which is part of the US Department of Health and Human Services (HHS)—is basically the CMS …

  • Stop the Denials! How to Report G-Codes so You Get Paid. Image

    webinarJul 25, 2014

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    It’s been more than a year since Medicare’s functional limitation reporting (FLR) mandate went into effect. You’d think everything would be hunky-dory by now. Unfortunately, though, rehab therapists have been forced to navigate more than a few hiccups and glitches—many of which cause claim denials. Exasperating? Certainly. Insurmountable? No way, José! Join WebPT founder and COO Heidi Jannenga and PT compliance expert Rick Gawenda of Gawenda Seminars as they tackle Medicare’s many FLR curveballs. In addition to …

  • The PT's Guide to Billing Image

    downloadJun 7, 2016

    The PT's Guide to Billing

    When it comes to physical therapy billing, you have to know your stuff—because even the simplest mistakes can cause denials. Of course, knowing billing backwards and forwards doesn’t have to be complicated. That’s why we created a comprehensive billing resource specifically for PTs. Take the guesswork out of billing. Enter your email address below, and we’ll send your free guide.

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    articleOct 27, 2016 | 33 min. read

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    articleNov 4, 2016 | 4 min. read

    MAC Madness: When and How to Contact Your Medicare Contractor

    Medicare providers have a lot of challenges to contend with—and meeting those challenges can be tough. But, you don’t always have to go it alone, because while you can’t always count on CMS to provide clear guidance on how to comply with all the regulations that apply to you, you do have other resources at your disposal when you need answers—quick. Let’s talk about one such resource: your Medicare Administrative Contractor (MAC). Your Medicare Go-To Even if …

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