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CMS proposes few changes to nursing facility code bundling, billing policies

07/25/2022

CMS plans to adapt the new CPT guideline changes to the nursing facility (NF) codes into its Medicare policy structure next year.

CMS will accept ED coding and guideline update, keep referral policies

07/25/2022

by: Julia Kyles, CPC

CMS accepted the update to emergency department (ED) E/M visits (99281-99285) that the AMA released in early July, but don’t expect the agency to drop existing policies on same-day critical care and ED visits and how to report the services of an ED physician and a second physician who treat the same patient in the ED.

New model for MIPS is coming, while Advanced APMs get a tough break

07/25/2022

by: Roy Edroso

For CY 2023 changes to the Quality Payment Program (QPP) and Merit-based Incentive Payment System (MIPS), CMS focuses its attention on the MIPS Value Pathways (MVP), a new measures regimen that begins on a voluntary basis in 2023. A mandatory adoption deadline remains fluid.

Fee schedule round-up: Coding, billing, policy and regulatory changes

07/25/2022

by: DecisionHealth Staff

Don’t miss out on additional policy changes contained in the proposed 2023 Medicare physician fee schedule, from supply cost revisions to enrollment updates. Get the latest here.

2023 specialty impact: Winners and losers under the proposed PFS

07/25/2022

by: Richard Scott

As providers brace for a nearly 4% cut to the 2023 conversion factor, the impact of relative value unit (RVU) changes on specialties is projected to fluctuate from a 5% gain for infectious disease to a -4% drop for interventional radiology.

Observation code crosswalk 2022 to 2023

07/18/2022

by: Julia Kyles, CPC

Observation-only E/M codes are slated for deletion as of Jan. 1, 2023. Part of the second phase of the E/M coding update folds observation codes into existing inpatient E/M codes and revises the inpatient codes’ descriptors. Use this crosswalk to train staff on the pending changes.

Proposed PFS chops fees 4%, approves E/M remake, previews code changes

07/18/2022

by: DecisionHealth Staff

Payment cuts are in the offing for Part B providers in 2023, along with a series of other projected changes targeting E/M services, COVID-related billing flexibilities and value-based care, according to the proposed 2023 Medicare physician fee schedule released July 7.

Navigate new combo observation/inpatient codes, more 2023 changes

07/18/2022

by: Julia Kyles, CPC

Juggling codes for observation and inpatient hospital services will soon be a thing of the past. The Jan. 1, 2023, update will shift facility visits, consults and home-based visits to a coding model based on medical decision-making (MDM) or time.

After abortion ruling, watch cross-border jurisdiction issues

07/18/2022

by: Roy Edroso

The legal consequences for providers and patients affected by the overturn of Roe v. Wade by the Supreme Court are still evolving, but experts warn that if those patients are in one of 10 states where abortion care is substantially illegal — even if the provider is not — doing more than consulting on the procedure can put providers in the crosshairs of state medical boards and law enforcement.

2023 E/M update will impact a range of high-volume codes

07/18/2022

by: Julia Kyles, CPC

The next E/M update will affect 69 codes from five code families and will go live in less than six months. Part B News analysis of Medicare Part B claims for 2019 and 2020 reveals that frequently billed E/M services in three of the impacted code families — inpatient hospital, emergency department and nursing facility services — exceeded several office/other outpatient codes.

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