Office of Billing Compliance

OBC Tips

• Avoid Overpayment Recoveries Related to Laboratory/Pathology Services
• Exempt PPS Inpatient Provider Billing Guidelines
• Possible Interventions and Potential Symptoms Increase, in the Emergency Room, So Does the Billing
• Diagnosis Based on Results of a Diagnostic Test
• What To Do When You Receive a Medical Record Request Letter
• Which Services Are Billed to Original Medicare in Qualifying Drug Trials?
• Physicians! Your Medical Records Play a Vital Role in Ordering and Providing DMEPOS to Your Patients
• National Coverage Determination (NCD) for Hyperbaric Oxygen Therapy
• Updates to Post-Procedural Admission Orders: Effective Monday, April 16
• Provider Compliance Tips for Negative Pressure Wound Therapy Fact Sheet
• Principal Investigator (PI) Responsibilities
• JW Modifier
• Medical Record Timeliness: What is Reasonable?
• Qualified Clinical Trial Cost Types That Are Not Billable to Subjects or Insurance
• Federal Requirements For Studies Submitted To The IRB
• Split/Shared Visits Documentation Guidelines
• Verifying Medicare Secondary Payer Data
• Outpatient Observation Services Post Procedures
• Documentation Requirements of Wound Care Treatment
• How To Properly Document and Code Pressure Ulcers
• Prolonged Services (Codes 99354-99359)
• National Clinical Trial (NCT) Identifier Numbers on Medicare Claims
• Use of Scribes
• Use of Modifier 59
• Enroll Clinical Research Protocols within 48 Hours
• Steps to Avoid Electronic Health Record Compliance Risks
• Outpatient Observation Services
• Admission Order Requirement for Inpatient Hospital Stays
• Correct Date of Service for Specific Services
• Managing Funds in a Clinical Trial and Billing for Services
• National Coverage Determination (NCD) for Hyperbaric Oxygen Therapy (20.29)
• Post-Operative Evaluation and Management (CPT 99024)
• Administration Charges
• Qualifying Clinical Trial Requirements
• Assistant At Surgery (Modifier 82)
• Billing Critical Care Services
• Admissions Involving Chemotherapy, Immunotherapy and Radiation Therapy
• Diagnosis Codes on Requisitions
• Ophthalmic Diagnostic Tests
• Same Day Diagnostic Cardiac Catheterization and PCI
• Proper Use of Medicare Coverage Analysis (MCA)
• Reducing Improper Medicare Payments
• Research Modifiers Q1 And Q0
• How Does an Advanced Beneficiary Notice (ABN) Influence A Medicare Payment
• Payors Are Watching Electronic Medical Record (EMR) Documentation
• Billing Acute Respiratory Failure (ARF) As A Primary Diagnosis
• Timeliness of Documentation
• Billing for Hospital Services
• Using TIME as a Determining Factor to Code a Visit
• Diagnosis Related Group (DRG) Payment When The Patient Is Transferred To A Post-Acute Care Setting
• Clinical Research Billing Compliance Risks
• Notes on the Documentation of History
• Written Notice of Potential Financial Liability for Hospital Services
• How to Avoid Double Billing
• Use the “Copy Forward” Functionality with Caution
• Observation Services Tip
• Medicare Coverage of Clinical Trials, Prospective Studies, and Registries
• Documentation of Physician’s Presence in the Operating Room
• Dose of a Drug Versus Units Billed for a Drug
• Tips To Avoid Clinical Research Billing Errors
• CMS: CT Scans
• Discharge Care and Acute Care Transfer
• Informed Consent Form (ICF)
• Anesthesia Medical Direction Rules
• Off-Campus Provider-Based Department (PBD)
• Research Billing:“Reasonable and Necessary”
• Medicare Part B and DMEPOS Beneficiary Services
• JW Modifier
• What is a Coverage Analysis
• Services Not Included in the Global Surgery Fee:
• Hospital Billing Observation Services
• Avoid Clinical Research Billing Errors
• 2016 Inpatient Only List
• Observation Services Are Covered Only When:
• Teaching Physicians Who Seek Reimbursement
• Medicare Coverage Analysis
• Submission of Diagnoses and Prohibited Practices for Clinical Laboratories
• Revised Exceptions to “Two-Midnight Rule”
• Teaching Physician Attestations
• Process for Obtaining Child Assent and/or Parental/Guardian Permission
• Hospital Admitting Diagnosis
• Advanced Care Planning Codes 99497 and 99498
• Two New E/M Codes in 2016 for Prolonged Services
• What Does the Z00.6 Diagnosis Code Tell the Payor and When is it Required?  What is Condition Code 3
• Acute Hospital Readmissions without Condition Code B4 or 42
• Several Provisions “Timeliness” When Talking About Documentation.
• Observation Services Tip
• Coding Tip: Evaluation and Management Services
• Enroll Clinical Research Protocols within 48 Hours
• Admission Order Requirement for Inpatient Hospital Stays
• Teaching Physicians Must Add Their Documentation
• More Volume of Documentation is Not Always Better
• The Use of an FDA-Approved Drug or Biological is Covered if:
• Research Modifiers
• Off Campus Medicare Outpatient Coinsurance Notice
• Banish the Words ‘Routine’ or ‘Here for Follow-Up’
• Proper Claims for Clinical Trials
• Present on Admission (POA)
• How to Use Modifiers to Indicate the Status of an ABN
• Principal Investigator (PI) Responsibilities