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Payments for 99214 climb as claims hit highs, while other E/M codes fall

01/29/2018

You may want to light a few candles to celebrate your recent success: As practices nationwide continue to pivot to higher-level E/M codes, they have faced little resistance and are returning record payments for some oft-used codes.

In #MeToo era, tighten up sexual harassment training and policies to avoid big settlements

01/29/2018

by: Roy Edroso

In an era of heightened awareness, it’s more important than ever to make sure your sexual harassment policy is clear, effective and followed.

CMS will hold claims over therapy cap exception; CHIP, Azar approved

01/29/2018

by: Roy Edroso

After Congressional inaction allowed the Medicare therapy cap exception to expire as of Jan. 1, CMS tells Part B News that it will hold all Medicare claims with the KX modifier “for a short period of time” to make billing those claims easier if, as hoped, Congress reinstates the exception retroactively.

When your PA indicates surgery, stick to global-period timelines to code correctly

01/29/2018

by: Richard Scott

Question: We have a physician assistant (PA) who sees a patient under the doctor’s supervision for the patient’s first few visits. During those visits, surgery is indicated and the patient then sees the physician to discuss and consent to surgery. Can the physician bill for this visit or is it considered part of the pre-op package? Sometimes surgery is already scheduled before the patient sees the physician. When the surgery is already scheduled but it is the physician’s first time seeing the patient, can this visit be billed?

NPPs, other lower-billing specialists see 99214 payments on the rise

01/29/2018

by: Richard Scott

The steady increase of 99214 encounters, which topped 103.6 million visits in 2016, was largely the product of non-physician practitioners (NPPs) and other specialty groups — including hematologists/oncologists, neurologists and urologists — filing more claims, according to a review of historical Medicare claims data.

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