This is the reference page for all the links and tools we have given you. If you save any page to your favorites, this would be the smart one to choose. As of 09/29/16 I have updated this page to link to the article that each spreadsheet or link refers to. The articles have detailed explanations and this change will make navigating the blog considerably more convenient.
Medicare Links:
Medicare Immunizations: http://www.cms.gov/Medicare/Prevention/Immunizations/index.html
Please reference Medicare and Immunizations
Medicare Fee Schedule Look Up: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PFSlookup/index.html
Please reference Please post your payments
High Risk Indicators for Medicare: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/cancer_screening.pdf
Please reference Everything you ever wanted to know about pap smears
Other Links:
Place of service listing: http://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set.htmlhttp://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set.html
Please reference Place of service listing
Insurance Commissioner: http://www.insurance.ca.gov/
Please reference The insurance denied your claim, now what?
Billing Tools:
Please reference Modifer 25 and 59
Please reference Everything you ever wanted to know about pap smears
Please reference Cash in the Office
Please reference Timely filing limits
Please reference Modifiers 24 and 79
Please reference Place of service listing
Depression screening guide
Appeals Tools:
Please reference The insurance denied your claim, now what?
Medical necessity template appeal letter
Please reference The insurance denied your claim, now what?
Example of a letter requesting retro authorization
Please reference Every practice does it…
Example of a letter requesting retro authorization for a MR Risk HMO
Please reference How to bill Medicare HMOs
Downloadable non-contracted patient guide
Please reference Every practice does it…
Psych Tools:
Please reference Psych Secrets
List of county mental health carve outs
Please reference Medi-Cal and Psychiatry (Tip: It’s a Mess)
Flow chart for Medi-Cal psych claims
Please reference Medi-Cal and Psychiatry (Tip: It’s a Mess)
Workers Comp Tools:
OMFS Schedule – For claims older than 2014. California uses the Medicare fee schedule as of 01/01/14.
OMFS Fee schedule for pharmeceuticals
Front Desk Tools:
Please reference The front lines in the battle for your A/R
Practice Managing Tools:
2014 PQRS Individual Measure Spec Manual
Please reference Medicare PQRS reporting
2015 PQRS Individual Measure Spec Manual
Please reference Medicare PQRS reporting
2015 PQRS Implementation Guide
Please reference Medicare PQRS reporting
Insurance Guidelines and Tools:
New Generation Billing 
Modifier 25 issue – Patient see’s PCP and is only charged for E/M. On the same day the patient also see’s Cardiologist and has an unscheduled procedure. I am working on the Facility only charges. The E/M for the PCP visit does not get a modifier 25. The Cardiologist visit E/M gets the modifier 25 due to the separate procedure. All the charges are on the same UB. Am I correct in stating that a modifier 25 only goes on one (the cardiology) of the visits and not both E/M charges. Also, this would be for a Medicare claim.
Would this be covered under Medicare part A or Medicare part B? If you are billing on the CMS-1500 forms with CPT and ICD9 codes, then I can probably help, but if you are billing on UB04 forms, I have never learned how to bill on those. And what type of facility is it?