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Monkeypox PHE declared; tighten intake protocols, prep for anxious patients

08/15/2022

U.S. health agencies are now operating under a second public health emergency (PHE) due to the growing number of monkeypox infections in the country. While the declaration shouldn’t change day-to-day life for most providers, you may take it as a cue to increase surveillance and make preparations in case the formerly-rare disease finds its way to your door.

Use these new CPT codes for monkeypox tests, vaccines

08/15/2022

by: Laura Evans, CPC

Practices testing or providing vaccinations for monkeypox will find it easier to bill for those services. The AMA on July 26 issued one new clinical lab test code and two vaccine codes for the virus, effective for use immediately.

Telemedicine or telescam? Heed the warnings in the latest special fraud alert

08/15/2022

by: Julia Kyles, CPC

Physicians and non-physician practitioners who are approached by recruiters from a telemedicine company should read the latest fraud alert from the HHS Office of Inspector General (OIG) before they opt to get involved.

Provider beware: OIG issues 7 signs of a telemedicine scam

08/15/2022

by: Julia Kyles, CPC

Physicians and other qualified health care professionals should check a recruiting telemedicine company’s pitch against the seven signs of a problematic arrangement that the HHS Office of Inspector General (OIG) included in its special fraud alert “OIG Alerts Practitioners to Exercise Caution When Entering into Arrangements with Purported Telemedicine Companies."

Know your rights for medical record access in post-Roe landscape

08/15/2022

by: Roy Edroso

It is expected that prosecutors will seek medical records to support charges against patients they suspect of violating new statutes against abortion, either as evidence of illegal treatment or to determine from notes that the patient sought such services. HIPAA offers some limited protection to practices that don’t want to give them up, and case law suggests the Privacy Law actually prohibits the surrender of protected health information (PHI) in some circumstances.

NPs set to benefit from the domiciliary, home visit merger

08/15/2022

by: Julia Kyles, CPC

Nurse practitioners (NP) will find it easier to report visits in the domiciliary and home settings when the next E/M update goes into effect Jan. 1, 2023. The update will delete the code family for domiciliary, rest home and custodial care services (99324-99337) and fold the services into the home services family (99341-99350). That code family will be renamed “home or residence services.”

Watch for revised MDM, new guidelines in the ED code update

08/08/2022

by: Julia Kyles, CPC

Focus on codes 99281, 99282 and 99283 when you study the revised descriptors and guidelines for emergency department (ED) E/M visits recently released by the AMA. The end of the three-component concept — history, exam and medical decision making (MDM) — for all level-based E/M codes prompted significant changes to these codes and will go into effect Jan. 1, 2023.

Proposed ACA rule adds language, oversight roles, advances LGBTQI+ care

08/08/2022

by: Roy Edroso

HHS and its Office for Civil Rights (OCR) unveiled a new proposed rule on July 25 interpreting the civil rights protections covered by Section 1557 of the Affordable Care Act (ACA). The rule contains new sections on “gender-affirming” care, though many providers will find extra training, oversight and language services that they may be required to provide more pressing to their practices.

Speed E/M code selection with a family-to-place-of-service crosswalk

08/08/2022

by: Julia Kyles, CPC

Help your staff connect E/M visits in the nursing facility and home with the correct place of service (POS) code with an E/M-family-to-POS crosswalk.

CMS proposes to bundle pricey skin substitute products in pro fee

08/08/2022

by: Laura Evans, CPC

A year after it finalized a policy to allow carrier-priced payment in the physician office for some synthetic skin substitutes, CMS is proposing more dramatic reimbursement changes for the implants. Specifically, the agency wants to bundle payment for these often expensive wound care products into the physician’s professional payment as “incident-to” expenses starting in 2024.

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