New HCPCS Modifiers for 2017 Impact Reimbursement Rates

  • Margaret Klasa DC, APN BC
  • Dec 05, 2016
  • Comments
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The Centers for Medicare & Medicaid Services (CMS) has established 2 new HCPCS modifiers that will affect reimbursement rates for the year 2017. The first new HCPCS modifier is FX, which is X-ray taken using film. The Consolidated Appropriations Act of 2016 (Section 502(a)(1)) Medicare Payment Incentive for the Transition from Traditional X-Ray Imaging to Digital Radiography and Other Medicare Imaging Payment Provision amends the Social Security Act by reducing the payment amounts under th ...

Context 4 Healthcare, Inc. announces the latest addition to the Medicare pricing capability of the DecisionPoint Pricing System – End Stage Renal Disease

  • John Danza
  • Sep 12, 2016
  • Comments
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Context 4 Healthcare, Inc . , a leading provider of healthcare compliance and pricing solutions, announces today the implementation of the End Stage Renal Disease Medicare Prospective Payment System (PPS) as the latest addition to Context’s DecisionPoint Pricing System™. The DecisionPoint Pricing System is the first solution in the healthcare industry to provide automated, real-time access to accurate Medicare fees for pricing healthcare claims during adjudication. When health plan ...

Context to Showcase Dental UCR as Exhibitor at NADP Conference

  • Kate Armbruster
  • Aug 25, 2016
  • Comments

Context 4 Healthcare will showcase its Dental UCR solution as an exhibitor at the National Association of Dental Plans ( NADP ) Converge 2014 conference, taking place September 15 – 18, 2014 near Orlando, FL. NADP’s Converge 2014 conference will bring together the leading experts, panelists, and vendor resources within the dental benefits industry. Although this is the first year Context has been included as a vendor at the NADP Converge conference, the year 2014 marks the 15 th yea ...

ICD-10 Grace Period: The End is Near

  • Margaret Klasa DC, APN BC
  • Aug 05, 2016
  • Comments

On October 1, 2016, the joint initiative between the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA), also known as the “grace period” will come to an end. The one year “grace period” allowed unspecified ICD-10-CM codes to be submitted on Medicare Part-B physician claims. The grace period was created to help ease the transition from ICD-9 to ICD-10 coding systems for physicians. While Medicare required the correct level of ICD- ...

Finding Healthcare Fraud in ICD-10 Using ICD-9 Investigation Schemas

  • John Danza
  • Jul 08, 2016
  • Comments
Finding Healthcare Fraud in ICD-10 Using ICD-9 Investigation Schemas

An ongoing concern within every payer’s special investigation unit (SIU) has been how to adapt existing investigations and future analytics to ICD-10 codes. The thought of having to recreate years of investigative knowledgeware is daunting enough, but the thought of having to figure out the ICD-10 equivalents of the ICD-9 based knowledgeware make it feel akin to climbing Mount Everest. But those ICD-10 codes are hiding out and getting exploited, so something must be done. Con ...

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