​First Coast Service Options Issues Guidance for Avoiding Code G2211 Denials

According to First Coast Service Options, Inc., the Medicare Administrative Contractor (MAC) for Florida, Puerto Rico, and the U.S. Virgin Islands, has been receiving a flood of appeals requests for denials of HCPCS code G2211 when billed with an office and outpatient (O/O) E/M service (CPT® codes 99202-99205 and 99211-99215) appended with modifier 25 because National Correct Coding Initiative (NCCI) edits do not apply in this scenario.

Billing Guidance CPT® code 76145

The Centers for Medicare and Medicaid Services (CMS) along with the American College of Radiology (ACR) recently provided billing guidance on procedure code 76145, Medical physics dose evaluation for radiation exposure that exceeds the institutional review threshold, including reports. Primarily developed for estimating fluoroscopic peak skin dose, code 76145 could also be used for other organ-specific dose evaluations for interoperative radiation therapy.

RCCS is honored to spotlight Ashley Mulaik Hunter, Manager of Financial Analytics, as she prepares to present at the distinguished RBMA PaRADigm 2024 conference later this month. In her session, “Proactive Process Improvements with Data Analytics,” Ashley will provide an expert analysis on leveraging data analytics to enhance the efficiency and effectiveness of healthcare practices, particularly through minimizing denials.

​​With a career dedicated to the intersection of healthcare finance and technology, Ashley Mulaik Hunter has consistently been at the forefront of identifying and implementing innovative solutions for optimizing revenue cycles across various healthcare settings.

In an era where technology increasingly intersects with healthcare, artificial intelligence (AI) emerges as a beacon of innovation, promising to redefine the contours of medical diagnostics and treatment. Healthcare is on the cusp of unlimited possibilities to integrate AI including large language models (LLMs), foundational models, multimodal fusion, and more. We are facing a massive challenge of healthcare burnout due to tedious duties and a shortage of qualified workers. There are high demands for faster and more accurate turnaround times with the expectation that a promising treatment or even cure is always around the corner. We have the opportunity to streamline medicine from predictive to diagnostics and treatment. 

Radiologist shortages. Recruiting challenges. Compensation struggles. Benchmarking confusion. Maintaining independence. AI concerns. 
 
The field of radiology faces constant challenges and opportunities for improvement, and staying ahead requires not just insight but foresight. From the recruitment of essential talent to navigating the evolving landscape of artificial intelligence, every radiologist and healthcare professional faces critical decisions that will shape the future of patient care. ​ 

Discover the Top 5 Challenges: Get an insider's look into the most pressing issues facing radiology today. ​

The first few years for a radiation therapist are unlike any other time in their career. They have learned a lot while earning their degree and obtaining their American Registry of Radiologic Technologists (ARRT) certification. However, they are just starting to gain real experience with patient care.  

While patient care remains the top priority for radiation therapists, it’s important to acknowledge their involvement in charge capture and billing. Who is better than the person providing the services to the patient to capture the representative codes? Even if they’re not tasked with reporting billing codes or fully grasping billing intricacies, therapists bear the responsibility of doing their best to get it correct.  
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CGS Wins the Rebid for A/B MAC Jurisdiction 15

On November 30, 2023, the Centers for Medicare & Medicaid Services (CMS) announced Celerian Group Company (CGS) Administrators was re-awarded the Part A/Part B Medicare Administrative Contractor Jurisdiction 15 contract. This seven-year contract includes the states of Kentucky and Ohio.The A/B MAC Jurisdiction 15 comprises approximately 4.8% of the overall national Medicare FFS (fee-for-service) Part A and Part B claims volume, equating to more than $23.5 billion in Medicare benefit payments annually. CGS contract will provide Medicare services to more than 325 hospitals, approximately 55,381 physicians, and 1.6 million beneficiaries.  

Possible Permanent Extension Medicare Telehealth Flexibilities

​Members of Congress will consider legislation which could extend telehealth flexibilities that were a result of the COVID-19 public health emergency, including Medicare reimbursements for virtual visits and access to online care for people who are underinsured.