Anthem has updated its professional reimbursement policy. This policy change requires that claims with physical medicine services 97010-97799 will require modifier GP. The modifier is required for dates of service after April 1, 2021. Any PT now billed to Anthem will require the GP modifier. Note this modifier may be Read more…
It’s official: California workers’ compensation has a new Medical-Legal Fee Schedule (MLFS). These new fees and codes took effect on April 1, 2021. This will affect all QME’s of course, but also a provider who is providing a report for a disputed medical fact. There is a complete change to Read more…
CMS is temporarily holding claims from providers in anticipation of legislation that will extend the suspension of the 2 percent Medicare sequester. The Med Learn Network Connects newsletter from March 30 stated that CMS has “instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on Read more…
This act specifies that clinical notes collected in an electronic format must be made available in that format and made available free of charge to patients. Practices may continue using paper charts, and if you do not use electronic records, the 21st Century Cures Act likely has little impact on Read more…
JUST A REMINDER!!! 97026 & 97016 CIGNA WILL STOP PAYING THESE CODES Effective March 15, 2021, Cigna will NO LONGER pay for Heat Lamp 97026 & Vasopneumatic Devices 97016. It is effective for claims with dates of service on or after March 15, 2021. A letter from Cigna was sent Read more…
California Division of Workers’ Compensation (DWC) announced the 2021 reimbursement changes to the Physician Services section of the Official Medical Fee Schedule (OMFS), to conform to relevant 2021 changes in the Medicare payment system as required by Labor Code section 5307.1. Fees for evaluation and management (E&M 99202-99205 and 99211-99215) were Read more…
Medicare is scheduled to make a significant reduction in Medicare rates in 2021. All Medicare provider groups are forming a coalition to block these scheduled cuts and there are things that you may do. Several members of the House introduced H.R. 8702, the Holding Providers Harmless from Medicare Cuts During Read more…
New Guidance on Federal Relief Fund Specifically Mentions Chiropractors In guidance released late last week, the U.S. Department of Health and Human Services announced the latest Provider Relief Fund (PRF) application period has been expanded to include provider applicants such as residential treatment facilities, chiropractors, and eye and vision providers Read more…
2021 ICD10-CM Updates 2021 update 10-1-2020 72,616 Codes 490 Additions 58 Deletions 47 Revisions As occurs every October 1 there are additions and deletions to the ICD10 code set that is effective on October 1, 2020. Though these are 2021 codes the effective date is October 1 of the prior Read more…
September 15, 2020 – Shortly after releasing the 2021 Current Procedural Terminology (CPT) code set, the American Medical Association (AMA) added two more codes related to COVID-19, including one that accounts for the extra safety protocols providers are taking to care for patients during the global pandemic. CPT code 99072 is a new practice expense Read more…