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08/16/2021
A recent advisory opinion (AO) from CMS explicitly answers a question about whether acquiring subsidiary practices is acceptable under the Stark Law, and some experts suggest it will encourage more practices to do so. That may further fire up an already hot practice acquisition market.
08/16/2021
Accurately reporting CPT codes for psychiatric care services can be challenging, especially when these services are provided in conjunction with a primary E/M service.
08/16/2021
Question: We know that if we’re not careful our cloned notes can lead to inappropriate data in an encounter record, which in turn can lead to denials and takebacks. But can you be prosecuted for fraud because of cloned notes?
08/16/2021
Question: We are considering the following policy for E/M visits: Coders can’t select moderate risk because a social determinant of health (SDOH) affected the diagnosis or treatment, unless the note supports an SDOH diagnosis code from the Z55-Z65 range (Persons with potential health hazards related to socioeconomic and psychosocial circumstances). That way we can make sure the risk level is supported by the note.
08/16/2021
Question: The doctor asks to not charge a patient for any of their visits. The patient has Medicare. Is it legal to bill Medicare and write off the patient’s portion or to write off the entire charge and not bill Medicare at all?\
08/16/2021
No matter the setting, you can expect a reduction in payment for a large swath of E/M codes in 2022, according to a Part B News analysis of payment adjustments mandated within the proposed 2022 Medicare physician fee schedule.

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