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Reporting requirements, scoring are most disliked parts of MIPS, survey says
10/15/2018
by: Richard Scott
As year two of the Quality Payment Program (QPP) winds down, practices report ongoing challenges with CMS’ full-bore pivot to value-based care and dissatisfaction with specific elements of the program, according to a survey from the Medical Group Management Association (MGMA) in Englewood, Colo.
Top specialties for each outpatient E/M code, 2017 (with denial rates)
10/08/2018
by: Roy Edroso
The full set from this week's benchmark. 
E/M update: 99214 now the most-reported outpatient code; total denials shrink
10/08/2018
by: Richard Scott
Take a close look at the trend lines behind outpatient E/M encounter codes 99211-99215 and you’ll discover a clear pattern over the past half decade or longer — higher-level codes are spiraling upward, while lower-level codes are witnessing significant declines.
Check frequent RARC/CARC combos to cut down on denials, save time
10/08/2018
by: Roy Edroso
Denial codes that come back on a transmittal with your rejected or denied claim are your first opportunity to find out why it didn’t go through — and if you know how to read the combinations of claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs) they include, you can often grasp and address the issue quickly and save time on the troublesome denials management process.
Add new flu vaccine code to your master list for the 2018-2019 season
10/08/2018
by: Richard Scott
You can thank Medicare for providing a sneak peek of a new CPT code that’s taking effect Jan. 1 and plan ahead to integrate it into your roster of flu season billing codes.
Patient identification errors: Solve mistakes to reduce denials and risk
10/08/2018
by: Nicole Votta
It’s an all-too-frequent event: A patient registration representative checks in a patient and finds more than one record with the same name. Which is the correct record? And what are the consequences of choosing the wrong one?
Several specialties make a good show among most-used E/M codes
10/08/2018
by: Roy Edroso
The provider types that tend to make the most use of the 10 office E/M codes (99201-99215) are a mixed bag of specialists and primary care providers, but the big news in the most recent Medicare utilization numbers from 2017 is the continuing rise in use of the codes by nurse practitioners (NPs) and physician assistants (PAs).
New OIG RFI shows Stark reform push is real — but results may be small
10/01/2018
by: Roy Edroso

A new request for information (RFI) from the Office of Inspector General (OIG) on Stark law suggest that reform, a longtime topic of discussion among health care analysts, may be coming — but probably at a slower rate of speed than reformists would like.

As advance care planning booms, use 5 tips to expand your offerings
10/01/2018
by: Richard Scott
Practices have been part of a boom in advance care planning (ACP) in recent years, but CMS’ open-ended rules and the wide eligibility parameters for ACP codes 99497-99498 suggest plenty of room for growth.
Easing the conversation: A game to promote advance care planning
10/01/2018
by: Richard Scott

Practices that want to introduce a dose of levity into their advance care planning efforts can find an outlet in card games that steer patients through what are sometimes challenging conversations.

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