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Follow AHA Coding Clinic’s advice for marijuana, prescription opioid use

06/25/2018

As more states legalize the use of marijuana, you may see documentation of recreational marijuana use by patients. But don’t code it unless the clinician documents a problem associated with the drug’s use, according to the American Hospital Association’s (AHA’s) Coding Clinic second quarter guidance.

Conduct a mid-year MIPS check-up of your clinicians’ quality efforts

06/25/2018

by: Julia Kyles

It’s halfway through the reporting year for the quality portion of the merit-based incentive payment system (MIPS). If clinicians at your practice are reporting quality via claims, this is a good time to take stock of how they’re doing.

Dig into the CCI manual for guidance on ear wax removal, new patient visits

06/25/2018

by: Julia Kyles

Question: The CCI edits bundle established patient visits (99211-99215) into the ear wax removal procedure. Per this explanation, I would expect a CCI edit for new patient visits, but I don’t sae them. Can you explain why the edits are not in the code set?

Check the discharge: TCM claims should be backed by the inpatient discharge record

06/25/2018

by: Julia Kyles, CPC

Practices that perform transitional care management (TCM) services (99495-99496) should work with inpatient facilities to confirm the date a patient was discharged. The documentation for TCM services should include the date the patient was discharged from an inpatient facility, such as a hospital or skilled nursing facility. However, a comparative billing report performed last year found that some TCM claims did not have a matching discharge record from the facility.

06/25/2018

Have a question about the physician practice environment that you’d like to run by your peers? You can now tap into the expertise of your colleagues, as well as the editorial team of DecisionHealth, the publisher of Part B News, with two practice-focused forums.

CCI version 24.2 edits place caps on new therapy code, free up obesity counseling

06/18/2018

by: Richard Scott

Incorporate updated billing limits on specific counseling and therapy codes to avoid running afoul of the latest Correct Coding Initiative (CCI) guidance. Effective July 1, CCI version 24.2 edits target specific services that practices report hundreds of thousands of times per year.

OIG, CMS or DOJ? Look at options before making self-disclosure

06/18/2018

by: Roy Edroso

If you’ve detected a pattern of overpayment or other malfeasances at your practice that could bring the attention of the feds, in addition to repaying or correcting the issue, you should self-disclose – but first choose carefully among the agencies that offer this option.

New Medicare cards in the mail; MBIs available through portal

06/18/2018

by: Roy Edroso

Watch out for new Medicare cards in your office: CMS confirms that it has started sending out the new cards with new Medicare beneficiary identifiers (MBIs), and some of your patients may have already received them.

Patient unlikely to get AWVs on MA home visits — but check

06/18/2018

by: Roy Edroso

Question: One of our patient’s Medicare Advantage plans is offering its members home visits by a nurse. The nurse performs many of the same services that patients receive with they see their primary care physician for an annual wellness visit (AWV). Do I have to worry that they’ll perform AWVs on my patients without telling me about it and cause confusion and lost charges when I try to bill them?

Final ICD-10-CM update for 2019 includes 38 more changes than proposed

06/18/2018

by: DecisionHealth staff

Providers will have a total of 473 code changes beginning Oct. 1, including 279 new codes, 143 revised codes and 51 deactivated codes, according to the final list of changes issued June 11 by the Centers for Disease Control and Prevention.

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