Part B News Features
Question: How should compliance leaders navigate the complexities of data sharing and interoperability initiatives while maintaining strict adherence to HIPAA regulations? ... More
Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More
Part B providers reporting inpatient and observation care codes appeared to face minor but notable headwinds as they adapted to the AMA’s revised reporting guidelines in 2023. Payments increas... More
Question: How should compliance leaders navigate the complexities of data sharing and interoperability initiatives while maintaining strict adherence to HIPAA regulations? ... More
Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More
Part B providers reporting inpatient and observation care codes appeared to face minor but notable headwinds as they adapted to the AMA’s revised reporting guidelines in 2023. Payments increas... More
Tools
Prepare members of your treatment and coding teams for changes to the diagnosis code set that will go into effect Oct. 1, 2024. Download and share the Excel file that contains five spreadsheets.
Make sure your physicians and qualified health care professionals (QHP) are ready for their crucial role in reporting G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment tool, 5-15 minutes, not more often than every 6 months).
Benchmark of the Week
Part B providers reporting inpatient and observation care codes appeared to face minor but notable headwinds as they adapted to the AMA’s revised reporting guidelines in 2023. Payments increased for some of the oft-reported codes in 2023, but denial rates also crept up for some of the most-billed services.
Modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) continues to see high utilization. Providers reported it on more than 65 million claims in 2023.

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