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Behavioral health services continue to climb, revenue jumps

05/02/2022

The growth of two services that Medicare has approved in recent years — cognitive assessment service 99483 and behavioral health care management code 99484 — signals that practices are spending more time addressing their patients’ behavioral health needs.

CMS’ revamped split/shared policy could jeopardize physician payments

04/25/2022

by: Julia Kyles, CPC

Watch out for a hidden hazard lurking behind Medicare’s new split/shared rule. Experts say it could lead to lower compensation for practices, and medical societies warn the new rule will also disrupt patient care.

ICD-10-CM proposals cover 1,100-plus new codes, scores of changes

04/25/2022

by: DecisionHealth Staff

Brain illness and injury, with a focus on dementia-related diagnoses, occupy a high volume of the 1,495 proposed changes to the ICD-10-CM code set announced April 18.

Explain incident-to with a decision tree designed for common errors

04/25/2022

by: Julia Kyles, CPC

Warn your physicians: Auditors and investigators will not be forgiving if they discover that your practice profited from incident-to billing errors.

7 areas of common OCR enforcement reveal risky compliance snags

04/25/2022

by: Matt Duffy

In January, the Office for Civil Rights (OCR) released its latest round-up of HIPAA “enforcement highlights,” and the years’ worth of data reveals weak spots for medical practices, covered entities (CE) and business associates (BA). Be mindful of how you disclose and safeguard protected health information (PHI) to avoid a breach.

In 2020, COVID fueled a year of ups and downs for ABNs

04/25/2022

by: Julia Kyles, CPC

Providers issued fewer advance beneficiary notices of non-coverage (ABN) during the first year of the COVID-19 public health emergency (PHE) than they had in previous years, even as two ABN modifiers grew in popularity.

Feds signal a PHE cease. Expect some waivers, like Stark Law, to go when it does.

04/18/2022

by: Roy Edroso

Signs are emerging that the national public health emergency (PHE) related to COVID-19 is entering an end phase, and practices should start planning for a halt to some of their PHE-based flexibilities, such as referral arrangements, that likely are not going to survive it.

Coders should take charge when checking a sales rep’s advice

04/18/2022

by: Julia Kyles, CPC

Remind your providers that coders should fact-check a sales representative’s coding advice before the practice purchases a new product or device.

Unreliable ‘source’? Try others, and document the disagreement

04/18/2022

by: Roy Edroso

Question: One of our providers had an office visit with a cognitively impaired patient and her adult daughter, whom he considers the “historian” in the encounter for E/M level selection purposes. However, the provider suspects the daughter’s version of events may be incorrect. What should he do? And can the daughter’s testimony still be used to calculate E/M levels?

Unpack ICD-10-CM coding for open wounds and superficial injuries

04/18/2022

by: Sarah Gould

From common injuries to burns and poisonings, your coding staff must be familiar with Chapter 19 of the ICD-10-CM manual to ensure coding compliance. Review integumentary anatomy and ICD-10-CM coding for burns and other external injuries to accurately capture your patients’ conditions.

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