Author Archives: Staff Writer

CMS and Indiana Agree on Medicaid Expansion

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CMS Administrator Marilyn Tavenner and HHS Secretary Sylvia Burwell issued the following statement today after Indiana became the 28th state – plus the District of Columbia – to expand Medicaid under the Affordable Care Act. “With today’s agreement, Indiana will become the 28th state, plus the District of Columbia, to expand Medicaid under the Affordable Care Act. This agreement will Continue reading CMS and Indiana Agree on Medicaid Expansion→

Specific Modifiers for Distinct Procedural Services

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Specific Modifiers for Distinct Procedural Services (XE, XP, XS, XU) (new) Modifier 59, distinct procedural service, indicates procedures or services that are separate or distinct from other same-day services. Effective January 1, 2015, new XE, XP, XS, and XU modifiers may be used instead of modifier 59 to provide a more accurate means of describing why certain procedures with the Continue reading Specific Modifiers for Distinct Procedural Services→

AMA “Appalled” by Number of EP’s Facing Penalties Under 2015 Meaningful Use

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“The American Medical Association (AMA) is appalled by news from the Centers for Medicare and Medicaid Services (CMS) today that more than 50 percent of eligible professionals will face penalties under the Meaningful Use program in 2015, a number that is even worse than we anticipated.” “The Meaningful Use program was intended to increase physician use of technology to help Continue reading AMA “Appalled” by Number of EP’s Facing Penalties Under 2015 Meaningful Use→

New CPT codes for Clinical Laboratory Waived Tests

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CLIA regulations require a facility to be appropriately certified for each test performed. To ensure that Medicare & Medicaid only pay for laboratory tests categorized as waived complexity under CLIA in facilities with a CLIA certificate of waiver, laboratory claims are currently edited at the CLIA certificate level. Listed below are the latest tests approved by the FDA as waived Continue reading New CPT codes for Clinical Laboratory Waived Tests→