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5 E/M FAQs: Help clinicians catch up with coders to attain consistency

05/03/2021

With new rules in place and edits arriving in real time, you should ensure that your clinicians are up to speed with E/M coding and documentation.

Watch 3 basic errors, frequency to beat high denial rates on diabetes training

05/03/2021

by: Roy Edroso

Medicare’s two biggest educational services for diabetic patients have dismal denial rates, and experts say that providers who bill them have to be extra attentive to documentation details to beat the spread.

E/M coding scenario: Achieving a Level 5 established visit with MDM

05/03/2021

by: Nancy Enos, FACMPE, CPC-I, CPMA, CEMC, CPC emeritus

For the first time in more than two decades, the E/M office visit code set (99202-99215) is subject to a coding and documentation overhaul. As of Jan. 1, 2021, previously vital components of code level selection — the history and exam components — no longer factor into your level of decision-making. Instead, determining a level of service will come down to one of two components: Medical decision-making (MDM) or time.

Data access expands: Be prepared to share clinical notes with patients

05/03/2021

by: Marla Durben Hirsch

Your practice should take a look at how its clinicians document patient encounters and procedures. The new interoperability rule that bars information blocking requires providers to share electronic patient health information (ePHI) with patients who request it, and that includes clinical notes.

Coverage waivers continue as PHE gains another extension

05/03/2021

by: Richard Scott

The COVID-19 public health emergency (PHE) will last at least until July 2021 after HHS Secretary Xavier Becerra declared another extension.

Diabetes training, education codes up slightly, but no relief from denials

05/03/2021

by: Roy Edroso

Though CMS estimates that one in five Americans aged 65 years and over has either type 1 or type 2 diabetes, Medicare’s codes for services that help diabetic patients cope with their disease have not performed very strongly in recent years, and are beset with high denial rates.

Ransomware wrought havoc in 2020; sharpen tools, watch vendors to avoid breaches

04/26/2021

by: Roy Edroso

In a bad year for the security of medical records, 2020 saw ransomware infiltrate more medical practices and cause more damage than ever before. Now’s the time to review your vulnerabilities and consider upping your cybersecurity game.

The future of medical practice is touchless, socially distant: Experts

04/26/2021

by: Roy Edroso

The masked-up, socially distanced practice of today will look very much the same in the foreseeable future, predict experts and medical practice professionals who are tracking clinical and work trends in the industry.

OIG still watching PODs closely; review the list of suspect arrangements

04/26/2021

by: Marla Durben Hirsch

Before your doctors start or invest in a physician-owned distributorship (POD), make sure they know the arrangement will increase their compliance risk and be subject to intense scrutiny by investigators.

Sequester cuts delayed (again); MACs will reprocess docked claims

04/26/2021

by: Richard Scott

Providers gained a fresh reprieve from the sequestration payment adjustment that had been on track to dock 2% of Medicare payments starting April 1.

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