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E/M codes in ED top list of independent dispute resolution services

01/16/2023

Emergency department visits (99281-99288) topped the list of services that triggered a request for an independent dispute resolution (IDR) during the second and third quarters of 2022, according to a report on the newfangled payment dispute process.

MDM update includes 3 new problems addressed, 1 new risk category

01/09/2023

by: Julia Kyles, CPC

Reinforce your understanding of the new medical decision-making (MDM) requirements with tips from a physician who oversaw the E/M guideline updates.

Study the new problems addressed definitions

01/09/2023

by: Julia Kyles, CPC

You wouldn’t report a code if you didn’t understand its long descriptor. The same principle applies to the definitions for coding based on medical decision-making (MDM). The 2023 E/M update includes three additions to the number and complexity of problems addressed at the encounter element. Keep these definitions on hand until they’re fixed in your memory.

CCI version 29.0 aligns billing limits with 2023 coding adds, losses

01/09/2023

by: Richard Scott

You’ll find thousands of added code pairs, and even more deleted code pairs, as part of the latest Correct Coding Initiative (CCI) quarterly edits. Effective Jan. 1, the version 29.0 changes mark a year-end coding clean-up that resets coding pairs across all categories of services.

Omnibus spending bill dents Medicare cuts, extends telehealth flex

01/09/2023

by: Roy Edroso

The final version of Congress’ year-end appropriations bill for 2023, which President Biden signed into law Dec. 29, takes a bite out of the daunting 4.5% conversion factor (CF) cut to Medicare providers’ reimbursement that had been expected. Instead, the CF will drop by 2% for CY 2023.

Don’t try to DIY when you need alternative language options for ABNs

01/09/2023

by: Julia Kyles, CPC

Question: Medicare creates advance beneficiary notices of noncoverage (ABN) in English and Spanish, but the majority of our limited English proficiency patients speak Korean. Does our practice need to create an ABN in the appropriate language when an official version isn’t available?

All in the data: Watch OCR release of common HIPAA issues triggering enforcement

01/09/2023

by: Dom Nicastro

On Sept. 30, the Office for Civil Rights (OCR) released its fall 2022 data for enforcement. Covered entities (CE) and business associates (BA) should review this data to determine areas that most commonly trigger enforcement on behalf of the government’s regulator for the HIPAA Privacy and Security rules.

Diabetes education services recover slightly; DSMT, MNT beat MDPP

01/09/2023

by: Roy Edroso

Despite much CMS fanfare, the Medicare Diabetes Prevention Program (MDPP), never very popular to begin with, continued its dismal utilization numbers in 2021. Medicare’s other, less heralded diabetes education services, diabetes self-management training (DSMT) and medical nutrition therapy (MNT), have done better, but still took a hit in the pandemic.

Glimpsing the future: Legal challenges, COVID rules (again), new codes and more

01/02/2023

by: Part B News Staff

Welcome to our annual predictions issue, where Part B News attempts to peer through the chaos and pick out the pivotal events that will define the new year for medical practices. After scouring the minds of a host of industry insiders and asking our readers for their take on looming events, Part B News compiled 10 predictions touching on coming changes, updates, upheavals and trends.

PBN’s 2022 predictions: PHE, NSA? Yes. Vaccines, telehealth? Not quite.

01/02/2023

by: Part B News Staff

In our annual predictions issue, Part B News looks back on how well we fared calling shots during the previous calendar year. Heading into 2022, we staked a claim on the duration of the COVID-19 public health emergency, the fate of split/shared services, revenue projections and more. Here is an unabashed look at our 2022 results.

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