New CCI Edits from CMS – January 1, 2020 Updates

2020-01-03T17:46:07+00:00Billing Software, Compliance, ICD-10, MACRA, MIPS|

Important Information Regarding New CCI Edits from CMS Effective January 1st, 2020 CMS implemented new CCI edits.  Included in the new set of edits are several significant changes for Therapy CPT codes 97150 and 97530 are now listed as a Column 1 code with all of the PT and OT evaluation and reevaluation codes (97161-97168) and are not permitted to be billed on the same day as a PT or OT evaluation There is a new edit requiting a modifier 59 for CPT 97140 when billed with PT or OT evaluation Raintree has included these new CCI edits in [...]

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Getting ahead of new ICD-10 Claims Requirements


Beginning October 1, 2016, The Centers for Medicare and Medicaid Services will require claims filed in ICD-10-CM/PCS to be more specific.  This presents a number of challenges to healthcare providers, as experts are predicting “large spikes” in claim denials when the new requirements go in effect. Commercial payers leading the way Providers can avoid claim denials by getting out in front of the new requirements.  Larger commercial insurers are leading the way, already requiring greater specificity in claims, rejecting those with unspecified ICD-9 and 10 codes. “This has put focus back on physicians and the critical role they play in maximizing [...]

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Top 4 Crucial Revisions of ICD-10 for Medicare and Medicaid Payments


The International Classification of Diseases (ICD) is the conventional diagnostic tool used to monitor the prevalence and extent of diseases and health problems. The goal is to provide a picture of the general health situation of countries and populations. Those working in the medical field use ICD to classify health problems and diseases that are recorded on health and vital records, such as death certificates. You may be wondering what the revisions of ICD-10 might mean for your practice. At Raintree Systems, we are here to help clear up the confusion surrounding the transition. Revisions of IDC-10 Conversion The transitional changes [...]

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ICD-10 Implementation


Support for Implementing the ICD-10 System The implementation of new standards and best practices regarding electronic billing, record keeping, and medical information management has been a hot topic for several years, and with good reason. For our part, we have provided exceptional support to medical organizations with a wide range of electronic management systems, so we understand that these changes are understandable cause for anxiety. Physicians practicing in many states have voiced opposition to ICD-10 implementation and other forms of electronic management infrastructure on the basis that these systems will increase work load, create a load of redundant or unimportant information, [...]

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