MACRA – Final Rule

Medicare Physician Billing Services for Raleigh, NC & West Palm Beach, FL Breaking: Medicare finalizes sweeping changes to physician payments Today, the Centers for Medicare & Medicaid Services (CMS) released the highly-anticipated final rule implementing the Medicare physician payment reforms enacted as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). With […]


The Centers for Medicare & Medicaid Services (CMS) recently published some facts about ICD-10 intended to dispel myths and address common questions about the upcoming transition: The ICD-10 transition date is October 1, 2015 – The government, payers, and large providers alike have made a substantial investment in ICD-10. This cost will rise if the […]

CPT Changes 2013 – Carotid Angiography

The RUC Relativity Assessment Workgroup continues their mission of abandoning the component coding concept and bundling certain services into single codes based on their 75 percent rule.  For code pairs that are billed together greater than 75 percent of the time, new CPT codes are created that bundle multiple procedures into one single code.  Consolidation […]

CPT 2013 – Coronary Revascularization

As mentioned in my previous post, here are the new CPT codes for coronary revascularization (Table 1).  The new codes will help support reimbursement for treating sidebranches as well as the more complex interventions involving bypass grafts, chronic total occlusions, and ST-elevation myocardial infarction.  Effective January 1, 2013, you will no longer use 92980, 92981, […]

2013 CPT Coding Changes – Nerve Conduction Studies

A lot of confusion has existed among providers who do nerve conduction studies and try to bill for them.  Choosing the appropriate units, differentiating between motor and sensory nerves, with or without F-wave and H-reflex testing has generated a lot of questions over the years.  For 2013, hopefully the confusion will diminish.  CPT codes 95900, […]

Ob-Gyn Coding for Laparoscopic Hysterectomy

Do you sometimes get confused on what CPT code to use when a laparoscopic hysterectomy has been performed?  Here is some information that helps provide structure to the codes available.  Laparoscopic Hysterectomy can be divided into three major code sets.  Aside from CPT code 58548, the CPT codes in each code set are differentiated by […]

2013 CPT Coding Changes for Cardiologists

The trend continues in 2013 for modifications to the cardiology CPT codes.  Of particular interest are the changes to the coronary angioplasty, stenting, and atherectomy codes.  CPT codes 92980, 92981, 92982, 92984, 92995, and 92996 will no longer be used.  They will be replaced with 13 new codes which will help classify your services as […]

Billing for Transcatheter Aortic Valve Replacement (TAVR)

  Background Transcatheter Aortic Valve Replacement (TAVR) is a new technology for use in treating certain patients with aortic stenosis.  As an alternative to open heart surgery, a bioprosthetic valve is inserted percutaneously using a catheter and implanted in the orifice of the native aortic valve.  Potential benefits of this procedure are that it’s less […]

Avoid the 2013 e-Prescribing Penalty

The June 30th deadline is looming. If you don’t e-prescribe on 10 eligible encounters by this date, you will be subject to a 1.5% reduction on your 2013 Medicare Fee Schedule.  First step, determine if you are an eligible professional (EP) by clicking here.  Will the penalty apply to my EP? The 2013 penalty will […]

Intensive Behavioral Therapy for Obesity

Did you know that Medicare now has coverage provisions for behavioral therapy for obesity? Effective with dates of service November 29, 2011 and forward, Medicare beneficiaries with obesity are eligible for a series of face-to-face visits with a primary care physician. For these services, the Medicare Part B deductible and coinsurance are waived. MedLearn Matters […]