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News



Retina Doctor Going To Jail

An East Memphis ophthalmologist, Seth Yoser, MD, has been convicted of fraud and sentenced to 42 months in jail and has lost his medical license in two states. His problems started with splitting vials...
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Delay to Enrollment Requirement Announced

CMS announced today a delay in implementing phase 2 of the enrollment requirements that may have resulted in claim denials beginning April 5, 2010. The new effective date is January 3, 2011. Claims with an...
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Consolidated Billing and the ASC

MedLearn Matters MM6702 describes a new edit involving consolidated billing (CB) and facility services provided in an ambulatory surgery center.

Consolidated billing is defined as follows: Medicare Part A covers nursing facility stays under very...

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Life without Consultation Codes

One month after CMS eliminated outpatient and inpatient consultation codes, physicians find themselves seeking additional guidance. This is especially true for inpatient services. CMS does not provide a coding crosswalk to assist physicians in selecting...
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What’s New in Consultation Code Coverage

Medicare continues to change reimbursement rules, presenting challenges to ophthalmic practices. In 2010, coverage for consultation codes has been eliminated. Here's a sample of some of the many need-to-know questions we are receiving. To...
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Medicare Physician Fee Schedule 2010

The Defense Appropriations Bill (H.R. 3326) signed by President Obama, provides for a 60-day delay in the 21.2% cut in Medicare physician reimbursement scheduled to take effect on January 1, 2010. It is anticipated...

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CMS Eliminates Consultations for Medicare

The Federal Register, Vol. 74, No. 226 posted November 25, 2009, contains CMS’ final decision to eliminate both outpatient consultations (99241 – 99245) and inpatient consultations (99251 – 99255) for payment purposes. CMS cites...
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