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As CCM use increases, focus on 7 questions to ensure care targets are met

06/22/2020

You can expect chronic care management (CCM) to keep growing in the years to come, and high-volume management may cause care adherence to slip. Whether you’re doing it yourself or offloading to a vendor, make sure these seven care concerns are being met.

10 ways to kick-start your E/M 2021 prep and ensure a smooth switchover

06/22/2020

by: Julia Kyles, CPC

Don’t put off your preparations for the revisions to the office and other outpatient E/M codes (99201-99215) that will go into effect next year. Coding experts advise that practices keep an eye out for more information and share 10 tips and pointers that practices should do now to prevent a last-minute rush to get ready.

CCI July-effective update adds sky-high MUE values for core E/M services

06/22/2020

by: Julia Kyles, CPC

You might not believe your eyes when you see the new medically unlikely edits (MUE) for office E/M codes. The July 2020 update restores the codes that CMS deleted with an off-schedule revision and assigned an MUE value of 24 to dozens of services.

You can require a COVID test before a procedure, and some states may demand it

06/22/2020

by: Roy Edroso

Question: I see that as medical practices reopen and procedures are being done again, providers are requiring not only temperature checks but in some cases negative COVID test results before treating the patient. Is that allowed?

In ominous shift, DOJ targets providers owned by private equity firms

06/22/2020

by: Marla Durben Hirsch

Take note if your practice is considering or already in an investment deal with a private equity firm: The Department of Justice (DOJ) has begun to focus on providers owned by private equity investors, and compliance slip-ups could balloon into legal headaches.

Office the most popular POS for CCM; watch for claims filed from other locations

06/22/2020

by: Roy Edroso

The primary chronic care management (CCM) code 99490 and the complex CCM codes (99487, 99489) requiring extended time and elevated medical decision-making have been rising in utilization in recent years. Between 2017 and 2018, use of these codes rose 23%, 78% and 285%, respectively, according to the latest available Medicare claims data.

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