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4 changes to your practice that can make MIPS easier to ace

09/25/2017

Make your merit-based incentive payment system (MIPS) reporting easier and higher-scoring by streamlining some operations to prepare for the proposed 2018 regulations, which raise the floor of required measures from three to 15.

Sanders’ Medicare for all would bring in more patients — but depress payments

09/25/2017

by: Roy Edroso

Should Sen. Bernie Sanders’ Medicare-for-all legislation pass, experts think the likely outcome is more people going to the doctor — who may get less money for treating them.

Heed the ‘initial’ description of G0438 to get annual wellness visits cleared

09/25/2017

by: Richard Scott

Do your due diligence to ensure a patient has not yet received an initial annual wellness visit (AWV) to overcome elevated denial rates for code G0438 (Annual wellness visit, initial visit) and also watch that your billing period doesn’t overlap with other preventive services.

Look at tax ID, specialty to determine a patient’s new or established status

09/25/2017

by: Julia Kyles

Question: We have multiple practice locations... What happens when a patient leaves one practice, goes to a different practice and sees a new doctor of the same specialty? Is the patient new or established for his first visit with the new doctor at the new practice?

Limit reporting office visits with debridement codes to rare circumstances

09/25/2017

by: Richard Scott

Question: My doctors are concerned that when patients come to our office for wound care (debridement of an ulcer), they are losing money by not being able to bill a separate office visit. I have explained that modifier 25 (Significant, separately identifiable E/M service) has limitations, but their argument is that they may be changing medications, off-loading shoes, orthotics, etc., to accommodate the wound and the area surrounding that. My question is: With enough documentation, can they bill the office visit too?

Specialists seize a chunk of the $31 million in CCM payments

09/25/2017

by: Richard Scott

Many specialty groups beyond primary care took in significant chronic care management (CCM) payments in 2015, with the $31.3 million in reimbursement spread across dozens of specialties.

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