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From HIPAA to referral laws, stay connected with the compliance rules for telehealth

03/15/2021

Practices must be careful about the compliance rules for coding and billing telehealth services, or they will be vulnerable to investigations and fines that could eradicate revenue.

FDA issues emergency authorization for new COVID-19 antibody treatment

03/15/2021

by: Sarah Gould

The Food and Drug Administration (FDA) recently issued an emergency use authorization (EUA) for the combination treatment of bamlanivimab and etesevimab for COVID-19 patients at high risk for severe infection.

Take cues from the note: How to navigate ‘acute’ and ‘chronic’ conditions

03/15/2021

by: Laura Evans

Question: We are struggling to get our providers to document whether the problems they are treating are acute, chronic or acute on chronic. I have not found a guide or publication that instructs coders what to do if this important information is missing except to query the provider. This is causing a lot of upset within our office and I’m wondering if this is one of those issues for which we should create our own internal policy for documentation?

New RUC chair signals the AMA’s commitment to digital health

03/15/2021

by: Julia Kyles

The incoming leader of the influential AMA/Specialty Society Relative Value Scale Update Committee (RUC) appears to be another sign of the AMA’s focus on digital health care.

More Levels 4 and 5 office visits fuel payment gains, despite fewer E/Ms overall

03/15/2021

by: Richard Scott

While the total number of established E/M office visit claims (99211-99215) decreased in recent years, providers still netted a payment increase because of a continued use of Levels 4 and 5 codes.

As watchdog focuses on AWVs and IPPEs, make sure to check timing, use clinical tools

03/08/2021

by: Roy Edroso

Beware of new scrutiny for your annual wellness visits (AWV) and the Welcome to Medicare service — one such code that usually carries a modest denial rate has shown an alarming percentage of improper payments. Make extra sure you’ve fulfilled the basics when you bill them.

Stark law updates deliver eased opportunities for value-based collaboration

03/08/2021

by: Marla Durben Hirsch

CMS’ new rule updating the Stark physician self-referral law brings some welcome relief for physicians who want to participate in value-based initiatives but were afraid of violating the law’s strict referral ban.

E/M risk assessments: Build a strategy for achieving coding compliance

03/08/2021

by: Joe Rivet

As practices adapt to a new set of documentation guidelines for E/M office visits in 2021, the time is ripe to assess your risk — and prevent slip-ups.

Can you report patient whose license is a threat? Check local law, board rules

03/08/2021

by: Roy Edroso

Question: I diagnosed a patient with a seizure disorder. I told her to report the diagnosis to the Department of Motor Vehicles (DMV) as it may invalidate her license; I’m pretty sure she won’t do it. If I report her to the DMV myself, am I violating her confidentiality?

Subsequent AWV code surges over 3-year period; NPPs advance fastest

03/08/2021

by: Roy Edroso

While the volume of Welcome to Medicare visits has grown modestly and initial annual wellness visits (AWVs) have declined in recent years, the use of subsequent AWV claims has surged at a 26% growth rate.

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