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Interventional Views Blog

PHYSICIAN EXTENDERS – PROPER USE AND BILLING

While CMS rules regarding billing for physician extenders, including Physician Assistants (PA) and Nurse Practitioners (NP) and other Non-Physician Providers (NPP), have been published and consistent for several years, it is common to find practices that do not know or follow them. The purpose of this letter is to simplify the rules to help keep practices in compliance with CMS guidelines. This letter specifically covers rules for billing for an extender that is enrolled with CMS versus not enrolled, and when it’s appropriate to bill the extender as “Incident to”.

MODERATE (CONSCIOUS) SEDATION – EXTENSIVE CHANGES FOR 2017

Currently, for most of the interventional procedures you perform, reimbursement for moderate sedation is bundled into the procedure code, but that will soon change. For dates of service on or after January 1, 2017, reimbursement for the procedure and the moderate sedation will be separated.

Documenting Percentage of Stenosis

Whether you are documenting to meet PQRS Measure 195 requirements or are treating an arterial stenosis by PTA for medical necessity, it is the documentation of the percentage (%) of stenosis that counts. Terms such as “mild”, “moderate”, or “severe”, without the specified percentage (%) are not specific enough...

Documenting Vascular Interventional Radiology Procedures

When documenting your vascular interventional radiology procedures, it is important to remember your audience extends far beyond the referring physician. On a regular basis, your report is scrutinized by a multitude of non clinical staff such as coders, auditors, billers, payers, and medical reviewers to name just a few...
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