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Neoplasms, eyes, external causes dominate proposed new ICD-10-CM codes

04/30/2018

Providers could have 435 code changes to deal with starting Oct. 1 with 247 new codes, 139 revised codes and 49 invalidated codes, according to the hospital inpatient prospective payment system (IPPS) proposed rule released April 24.

As telehealth payments climb, OIG finds widespread billing errors

04/30/2018

by: Richard Scott

Practices that are ramping up their telehealth services should heed a recent OIG audit that found common errors on telehealth claims that may have – but maybe shouldn’t have – cleared CMS’ payment systems.

Set policy to handle impaired providers with process to assess, test, refer

04/30/2018

by: Roy Edroso

Have a process to route providers with drug and alcohol problems to appropriate treatment — being respectful of their rights while protective of your patients.

Resident can perform encounter solo, but teaching physician must confirm findings

04/30/2018

by: Richard Scott

Question: I have a question concerning residents and teaching physicians: If a resident sees a patient on Dec. 12 and the attending uses the date of service as Dec. 15, is this appropriate? The CMS guidelines for teaching physicians state that the physician must be “present” for the key components. I am hoping you can shed some light on this as I have reached out to CMS via email with no response.

Telehealth-based E/M encounters, psychotherapy services gain dollars

04/30/2018

by: Richard Scott

Providers are increasingly tapping into telehealth to conduct patient encounters, using the video-based technology to perform E/M services and psychiatric visits, according to a review of the latest Medicare claims data.

Try these 3 ways to reform, keep noncompliant patients before letting them go

04/23/2018

by: Roy Edroso

In this age of value-based care – and compensation -- experts see more practices “firing” patients who don’t follow doctors’ orders but say you should try to change the ways of noncompliant patients first.

Cryptojacking a new threat to your patients’ PHI; treat incidents seriously

04/23/2018

by: Roy Edroso

While ransomware and similar computer exploits are hitting medical practices, you also should be alert to another cyber-invader that can slow down your practice’s system and cause a security breach.

Document interactive contact for TCM services involving multiple providers

04/23/2018

by: Richard Scott

Question: After a discharge, primary care schedules the patient with the cardiologist, and the cardiologist completes all of the requirements necessary for transitional care management (TCM) services. Is this a valid TCM visit, even if the person who made the initial contact does not work for the cardiologist?

Not all NPP work with a doctor nearby can be claimed incident to

04/23/2018

by: Roy Edroso

Question: We have a non-physician practitioner (NPP) who works with our physicians, and all his work is claimed incident to. Sometimes I’m not sure it’s appropriate. I’m told that as long as the supervising physician is in the office when the NPP works and signs the claim, there’s no problem. Is that so?

TCM claimants improve as utilization goes up, denials go down

04/23/2018

by: Roy Edroso

Claims for transitional care management (TCM) codes 99495-99496 are up and denials are down, but the rising tide is not lifting some specialties (like neurosurgery) nor some places of service (like inpatient hospitals).

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