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How to set E/M risk level when a different doc does the surgery

04/05/2021

Question: I am not sure how to set the risk level when a physician refers the patient for possible surgery that will be performed by a different doctor. For example, an orthopedic surgeon sees a patient with Dupuytren’s contracture and discusses the treatment options — Xiaflex injection or fasciectomy with the patient. Please help.

New rule delays MCIT ‘breakthrough technology’ effective date

04/05/2021

by: Roy Edroso

The effect of a last-minute Trump administration rule empowering more and speedier medical device authorization has been delayed by the Biden administration pending collection and analysis of new stakeholder comments.

Interrupted-service modifiers work great with some codes – but wipe out with others

04/05/2021

by: Roy Edroso

It may not be the high overall denial rates that best explain why the two interrupted-service modifiers, 52 (Reduced services) and 53 (Discontinued procedure), are so tricky; it could have something to do with the mix of codes that seldom, if ever, get denied with the modifiers, and those that get rejected most or all of the time.

Coders, clinicians report broad approval of new E/M guidelines, yet questions remain

03/29/2021

by: Laura Evans

They have lingering questions and scramble to keep up with corrections and updates, but coders and medical practice staff say they and their clinicians are mostly happy about this year’s revised E/M office visit guidelines and that the transition, so far, has been smooth.

Should you offer separate protocols for vaccinated patients? Experts advise wait-and-see

03/29/2021

by: Roy Edroso

With more Americans becoming vaccinated against COVID-19, you may be thinking about a change in patient infection protocols based on patient status. But it may be prudent to wait until you get more back-up from the law and government agencies.

Add appropriate sources and independent historians to your MDM calculations

03/29/2021

by: Julia Kyles

Don’t forget to track your clinician’s dialogue with outside sources: A practitioner’s conversation with a parent or a parole officer may be used to code Levels 3, 4 and 5 E/M office visits (99203-99205, 99213-99215).

Cue up best practices for ending pandemic-related work-from-home arrangements

03/29/2021

by: Courtney Bru

Many employers turned to telework during the COVID-19 pandemic. Often they will tell you the arrangements “weren’t perfect” but were necessary to survive the unprecedented circumstances.

Are you ‘information blocking’ if you don’t have an EHR? Not necessarily — at least for now

03/29/2021

by: Roy Edroso

Question: Our practice does not have electronic health records (EHR). Instead, we keep paper patient records. I understand the new information blocking rule that goes into effect April 5 requires that I give my patients their protected health information (PHI) in whatever format they request. Will I be in violation of the rule if I can only give them paper?

Vaccine admin payment rates remain down after cuts; COVID aims higher

03/29/2021

by: Richard Scott

Payment cuts to a series of immunization administration codes have significantly curtailed provider payments in recent years, as Medicare slashed rates for the G0008-G0010 series related to influenza, pneumococcal and hepatitis B vaccines.

Beyond physician burnout: Address staff fatigue as well to maintain practice health

03/22/2021

by: Roy Edroso

While physician burnout grabs headlines, practice experts believe you should also reach out to non-physician employees, from nurse practitioners to receptionists, who also may be suffering from critical stress in order to keep the whole practice humming happily and productively.

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