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Practices’ claim on top doc prospects getting weaker; recruit for staying power

07/05/2021

As fewer physicians enter the market from medical schools and practices cease to be the first choice of those who do, experts suggest you be mindful of the new doctors’ needs — but also recruit with an eye toward potential partners who will grow with you and vice versa.

Proposed uniform policy would reshape epidurals for chronic pain

07/05/2021

by: Julia Kyles, CPC

Review the proposed uniform policy for cervical/thoracic and lumbar/sacral epidural injections and use the open comment period to help shape the final policy.

Medical necessity for epidurals – proposed uniform policy

07/05/2021

by: Julia Kyles, CPC

Take note of the proposed medical necessity requirements for epidurals to treat chronic pain. Each service must meet all three of the following elements.

Part II: Plan ahead for a quicker records request mandate in the Privacy Rule

07/05/2021

by: Dom Nicastro

As HHS mulls significant changes to the HIPAA Privacy Rule, it’s likely that the 15-day requirement to share patients’ medical records could easily stick.

Using preventive prolonged service codes? Log at least 16 minutes over

07/05/2021

by: Roy Edroso

Question: Our provider did a depression screening billable with G0444 (Depression screening, 15 minutes) and went a little over the 15 minutes required. The provider thinks we should add the prolonged preventive service code G0513 (Prolonged preventive service[s] [beyond the typical service time of the primary procedure], in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes [list separately in addition to code for preventive service]). Our provider didn’t add anywhere near 30 minutes to the session, however. Can we still claim it?

Reminder: Relaxed NCCI edits have been retired; code accordingly

07/05/2021

by: Julia Kyles, CPC

Question: We often perform trigger points (20552-20553) on the same day that established patients come in for E/M visits (99211-99215). I heard that in 2020 Medicare said that we no longer need to append modifier 25 (Significant, separately identifiable E/M service) when the E/M takes place on the same day as a trigger point injection. Is that true?

Preventive services codes keep going up – and some pay big

07/05/2021

by: Roy Edroso

The series of preventive services codes that practices turned to most frequently did not change much between 2018 and 2019, except that their utilization continues to climb.

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