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2017 predictions: Increased cash payments, no changes to MACRA and more

01/02/2017

The new year has the possibility of being a time of unprecedented change in health care. Here’s how Part B News expects physician practices to be affected.

Our 2016 predictions: Right on lagging ACP use, MIPS; result of some predictions murky

01/02/2017

by: Richard Scott & Roy Edroso

Check out how Part B News and its experts fared with the 2016 predictions:

CMS will SHFFT to a new payment model in the summer of 2017

01/02/2017

by: Julia Kyles

CMS rolled out a final rule Dec. 20 outlining three new cardiac care models and one new orthopedic care model to start as early as July 1 as well as one new small-practice-friendly accountable care organization (ACO) track to start in 2018.

Don’t code pregnancy before testing — even if the patient claims it

01/02/2017

by: Roy Edroso

Question: A patient of a multispecialty group practice came in to see an internist. She reported herself pregnant — though this had not been medically confirmed... a few weeks later, the pregnancy was confirmed on a visit to our OB... Can the practice use the pregnancy O codes on the first visit, even though they plan to bill the confirmation code Z32.01 for the later ob/gyn visit?

Watch out for ambulatory surgery center payment indicator N1

01/02/2017

by: Julia Kyles

Question: Medicare denied 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]) when our ambulatory surgery center reported it with 20610 (Arthrocentesis, aspiration and/or injection, major joint or bursa [e.g., shoulder, hip, knee, subacromial bursa]; without ultrasound guidance). Can you explain why we’re getting this denial?

MIPS mash-up: About 38% plan to go beyond baseline, 40% remain unsure

01/02/2017

by: Richard Scott

The competition for a limited amount of incentive dollars tied to the merit-based incentive payment system (MIPS) may be fierce in 2017, as nearly two in five respondents to a recent medical practice survey said they would report multiple measures during the 2017 transition year.

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