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CMS wants total ACO Medicare by 2030. Experts aren’t so sure.

02/06/2023

CMS is touting the growth of three accountable care organization (ACO) programs — and predicts it will meet its goal of connecting all Medicare beneficiaries to ACOs by 2030. Experts aren’t so sure, though they do think Medicare’s ACO program is heading in the right direction.

COVID public health emergency to end May 11

02/06/2023

by: Roy Edroso

The Biden administration announced its intention to end the U.S. COVID-19 public health emergency (PHE) on May 11, 2023. In place since Jan. 31, 2020, the PHE has allowed numerous flexibilities within the Medicare program that will need to be either extended or wound down.

Part II: Follow AMA policymakers’ advice to succeed in hospital coding retool

02/06/2023

by: Julia Kyles, CPC

Find additional guidance on admission and discharge coding, the importance of social determinants of health (SDOH) and using time to report services.

Alert staff that PHI must stay secure, even when it’s of a family member

02/06/2023

by: Julia Kyles, CPC

Highlight the importance of an impenetrable work/life firewall when staff have access to the protected health information (PHI) of relatives, friends and other acquaintances. They can access the PHI when they stick to the rules. But if you ignore access rules, you risk exposing the practice to a HIPAA breach.

AMA unveils 22 new T codes for heart, joint procedures

02/06/2023

by: Laura Evans, CPC

Starting July 1, practices will have a diverse collection of new CPT Category III codes to use for procedures including pulmonary artery denervation, two-chamber leadless pacemaker implant and percutaneous sacroiliac joint fusion.

RPM services revved up in 2021; popularity swayed in some regions

02/06/2023

by: Julia Kyles, CPC

Remote physiological monitoring (RPM) continues to surge in popularity. A three-year review shows massive growth among the suite of RPM codes – 99091, 99453-99458, 99473-99474 – that debuted between the years of 2018 and 2020.

Use expert answers to improve hospital E/M documentation, coding

01/30/2023

by: Julia Kyles, CPC

Train staff on the new guidelines for inpatient and observation visits, effective Jan. 1, 2023, with answers from an AMA official who oversaw the landmark revisions to the level-based E/M codes.

Study suggests NPs in the ED cause care concerns. Not everyone agrees.

01/30/2023

by: Roy Edroso

A paper questioning the quality and efficacy of care by nurse practitioners (NP) in emergency departments is generating a good deal of press, as well as pushback from advocates for the growing role of non-physician providers in the U.S.

Take note of 4 major deletions in the 2023 NCCI manual

01/30/2023

by: Julia Kyles, CPC

Medicare makes it easy to spot additions to the annual National Correct Coding Initiative (NCCI) manual — new language is printed in red font. However, Medicare doesn’t flag information that has been deleted, revised or moved and Part B News found several notable deletions when it compared each chapter of the 2022 NCCI manual to the 2023 NCCI manual.

Sued for ransomware attack? Hacked health system hit with class action claim

01/30/2023

by: Roy Edroso

A patient has brought a class action suit against a health system, claiming its negligence led to the breach of privacy and potential harm for which the plaintiff seeks damages — an ominous sign for practices in a time of rising ransomware attacks.

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