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Risk reduction: For E/M office visits, let the clinician select risk to maintain accuracy

02/15/2021

Code faster and prevent improper payments for office E/M visits in one step: Ask the treating physician or qualified health care professional to select and document the level of risk. Doing so will also align your coding practices with the new CPT guidelines.

As practices wait for vaccines to appear, experts advise close patient check-ins

02/15/2021

by: Roy Edroso

The movement of COVID-19 vaccines through the health care system remains slow, and both providers and patients continue to be stressed and may have to cope with COVID workloads for a while to come.

For a revenue boost, consider adding remote patient monitoring to your practice

02/15/2021

by: Marla Durben Hirsch

Practices looking for a way to improve patient care and boost the practice’s income may want to look into — or increase their use of — remote patient monitoring, also known as remote physiologic monitoring.

Imaging services net $3.7B for practices, but watch for the spine X-rays

02/15/2021

by: Richard Scott

You may want to inspect your spinal X-rays a tad more closely: Of the most-reported imaging services performed in place of service 11 (Office), code 72100 (Radiologic examination, spine, lumbosacral; 2 or 3 views) fares the worst, with a denial rate over 13%.

After violent incident, assist authorities, pursue patient outreach measures ASAP

02/08/2021

by: Roy Edroso

A murder-suicide at a doctor’s office in Texas serves as a distressing reminder that, in addition to an active-shooter protocol, a physician practice should prepare a post-incident response to help employees and patients cope and insulate itself from liability.

Problem solving: Navigate ‘low’ vs. 'straightforward' MDM under 2021 rules

02/08/2021

by: Julia Kyles, CPC

Increase your understanding of the revised problem element for office-based medical decision-making (MDM) coding with the answers to questions posed during the CPT¨ and RBRVS 2021 Annual Symposium, Nov. 17-20.

As Open Payments expands, 4 tips to prepare for reporting to NPPs

02/08/2021

by: Marla Durben Hirsch

With changes on the horizon, it’s time to revisit your practice’s relationships with applicable organizations. Starting Jan. 1, 2021, companies and vendors will be required to track and report payments to non-physician practitioners (NPP) and report the information to CMS starting in 2022.

Most practices not adhering to HIPAA ‘patient access’ rules; ameliorate efforts now

02/08/2021

by: Matt Duffy

In the months before a transition to a new administration, the Office for Civil Rights (OCR) released the long-awaited 2016-2017 HIPAA Audits Industry Report, offering a look at the successes and shortcomings of select covered entities (CE) and business associates (BA).

Practices improve modifier 25 use; NP, PA activity surges

02/08/2021

by: Roy Edroso

Good news: Denial rates on codes claimed with modifier 25 (Significant, separately identifiable E/M service) remained low among the top 15 code combinations that practices submitted millions of times.

As Biden admin. takes shape, expect closer scrutiny on compliance, HIPAA, billing

02/01/2021

by: Roy Edroso

The advent of a new presidential administration is expected to bring changes in health care compliance enforcement: You should watch for the new wave of HHS, CMS and Department of Justice (DOJ) agencies to go after big health care-related crimes. They’re also likely to scrutinize HIPAA and the big payments made to help providers over the COVID-19 hump.

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