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CPT Assistant says no to mixing table of risk examples, CPT E/M guidelines

10/03/2022

When you train staff on the next update to level-based E/M services, remind them that they can’t play mix-and-match with the new guidelines and the 1995 or 1997 Documentation Guidelines for Evaluation and Management Services.

Quarterly edits bring in new bundled services, billing caps

10/03/2022

by: Richard Scott

You’ll find several hundred new code pairs added to the auto-bundling series of National Correct Coding Initiative (NCCI) edits. The billing updates, which include medically unlikely edit (MUE) additions and revisions, take effect Oct. 1.

One obstacle for more advanced med tech adoption: Malpractice

10/03/2022

by: Roy Edroso

One critical factor in physicians’ decisions to use new medical technology is a concern that the new tech may expose the physician or practice to liability claims.

Use the OIG’s data brief on telehealth to boost your compliance efforts

09/26/2022

by: Julia Kyles, CPC

Check Medicare claims data, review the new program integrity measures for telehealth services and consider other telehealth-specific risks to avoid compliance issues for these services. Those are three ways health care attorneys say that practices can incorporate guidance from a recent report on telehealth services into their telehealth compliance efforts.

OIG to CMS and legislators: Build program integrity into any new telehealth rules

09/26/2022

by: Julia Kyles, CPC

While legislators and policy creators debate permanent changes to Medicare’s telehealth rules, the HHS Office of Inspector General (OIG) issued a call to build program integrity protections into any changes. The agency included the reminder in its Sept. 2 data brief, “Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks.”

Physicians eager to tap into tech explosion, remote monitoring poised to surge

09/26/2022

by: Roy Edroso

A new study from the AMA shows physicians growing ever more comfortable with multiple forms of health care technology. The growth of telehealth is expected, but some tools that are also gaining fast, such as remote patient monitoring (RPM), may be less expected. Perhaps the biggest growth stock of all, though, is in the non-clinical area of price transparency and related data tools.

Congress debating path to flatten expected provider payment cuts

09/26/2022

by: Roy Edroso

Heads up: Congress is working up a bill to relieve providers whose reimbursement is set to take a sharp cut in 2023. But lawmakers seem inclined to take a different path than they did last year.

A brief history of remote physiologic monitoring, 2019-2020

09/26/2022

by: Julia Kyles, CPC

You need a scorecard to keep track of coding and coverage changes for remote physiologic monitoring (RPM) services in the E/M chapter of the CPT manual.

5 specialties led the charge for adopting remote physiologic monitoring

09/26/2022

by: Julia Kyles, CPC

Five specialties added new E/M remote physiologic monitoring (RPM) services to their practices in 2019 and continued to increase reporting in 2020. Internal medicine was at the head of the pack in 2019 and stayed there in 2020, according to a review of Medicare Part B data for 2019 and 2020, the latest available.

Prepare for 5 medical decision-making changes, more guidance in 2023

09/19/2022

by: Julia Kyles, CPC

Alert staff to the new and revised medical decision-making (MDM) guidelines before they go into effect Jan. 1, 2023. Your practice also will need to revise materials that are based on the current MDM table and definitions, such as scorecards and training materials.

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