Anesthesia MACRA Compliance Cheat Sheet

If you work in the medical field, you know all about MACRA – the Medicare Access and Chip Reauthorization Act that instituted the Quality Payment Program (QPP). QPP brings three programs together under one umbrella: PQRS, Meaningful Use, and Value Payment Modifier. Under the new system, there are quality reporting requirements that come along with […]

$68 Billion in Medical Billing Errors Creates High-Risk Situation for Providers

When it comes to medical billing errors, the numbers are staggering: as many as 80% of all medical claims submitted to insurance carriers contain errors costing approximately $68 billion. Additionally, the incorrect coding of about 55% of evaluation and management (E/M) claims has resulted in roughly $6.7 billion worth of erroneous Medicare payments.   Physicians […]

The ABCs of Qualifying Circumstances

Modifier codes are sometimes used to signal abnormal circumstances related to anesthesia care. These 5-digit qualifying circumstances codes are recognized as modifiers when they are billed as separate line items in order to report services that were provided under unusually difficult circumstances (i.e. unique operative conditions, extenuating issues with the patient’s condition, etc.). Read on […]

The ABCs of Calculating Anesthesia Time Units

It’s essential to stay vigilant when it comes to calculating anesthesia time units. Not properly doing so can result in delayed or denied claims, decreased revenue, and audits – which can have a negative impact on your practice’s reputation. Take a moment to look over this guide on the basics of calculating anesthesia time units […]

The ABCs of Physical Status Modifiers

Accuracy is essential when it comes to physical status modifiers in the anesthesiology field, and as of January 2016, the ASA Physical Status Classification System (modifiers P1-P6) includes examples to assist in choosing the appropriate modifier. The original version was published in 1941 by Meyer Saklad, and then by ASA in a booklet for the […]

The 4 Scoring Thresholds of MIPS

2017 is the year for clinicians to transfer to the new MIPS program, and CMS has done its best to make the transition as smooth as possible – especially for those who are just starting to participate in MIPS. For those clinicians who don’t participate at all, a score of zero will be assigned; but […]

The ABCs of MAC Anesthesia

You may have heard about MAC anesthesia, or maybe you know someone who experienced this type of sedation during surgery – but what exactly is it, and how does it differ from general anesthesia? These are great questions, and they concern a lot of people – especially those who claim they’ve been awake during surgery. […]

Are You Ready for MACRA? – New Survey May Disagree

In late 2016, the Centers for Medicare and Medicaid Services (CMS) published a final ruling on Medicare Access and CHIP Reauthorization Act (MACRA) implementation. The act, signed into law in 2015, represents a shift in health care payments away from volume-based pay and toward value-based pay reimbursement. Despite a 2017 launch date, the fifth annual […]

The ABCs of CPT Modifiers

Because of the complexity of medical procedures and services, additional information is often necessary when coding. This information typically comes in the form of what’s called a CPT modifier, which describes how many procedures were performed, why they were necessary, where they were performed on the body, how many surgeons were involved in the operation, […]