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Keep one eye on your private payers’ policies for E/M and prolonged services, the other on your denials and make sure you have a firm understanding of the differences between the AMA’s CPT guidelines and CMS rules for the services. You can reduce denials and improper payments if you understand where AMA and Medicare don’t see eye-to-eye on E/M coding.
The Texas Medical Association (TMA) won a court case against HHS and other agencies in February 2022, forcing them to make adjustments to their No Surprises Act rules. Now a federal judge has ruled that the Departments didn’t go far enough with the change, sending them back to the drawing board. 
by: Debbie Jones, CPC, CCA
You have more options to provide virtual services in 2023 with new platforms and ways to report them. Embrace the role of remote therapeutic monitoring (RTM), one of the latest services to enter the virtual landscape.
The heightened interest in artificial intelligence (AI) tools such as ChatGPT is a reminder that AI also has a place in health care even at the practice level, as a patient communication tool and in clinical decision support. Its computing power is quickly increasing; however, so far its old drawbacks remain in place.
Practices dialed back their use telephone E/M services (99441-99443) for Medicare Part B patients in 2021. However, the time-based codes remained popular with primary care providers.


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