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Medicare links up with private payers, expands colorectal cancer screening benefit

02/27/2023

Take note of an expanded benefit for colorectal cancer (CRC) screening. It’s likely to mean that providers will talk to more patients about the screening, billing staff will collect copays from fewer patients, and if your practice performs non-invasive CRC tests in-house, you’ll see an uptick in lab services.

CMS unveils inflation drug pricing changes, with a Part B wrinkle coming soon

02/27/2023

by: Roy Edroso

A flurry of drug-pricing activity at HHS and CMS shows the agencies looking forward to big changes in what they’ll pay pharmaceutical companies for Medicare drugs. Most of these won’t affect providers and patients directly for some time — except for one shift that will appear as early as April 1 for some practices that dispense Part B drugs.

E/M update includes review warning for time, no help for split/shared billing

02/27/2023

by: Julia Kyles, CPC

You’ll find Medicare’s new and revised rules for hospital visits, nursing facility visits, prolonged services and split/shared visits in CMS 100-04, Change Request 13064, released February 9. The update includes more information on documenting time-based visits but is silent on component-based split/shared billing.

Implant 2023 CPT code changes for integumentary procedures

02/27/2023

by: Savannah Schmidt

The AMA update to the 2023 CPT code set has brought three code additions, one revision and one deletion to the integumentary chapter. Ensure your staff is aware of the changes, effective Jan. 1, to avoid claims disruptions.

Top screenings remained suppressed, down 3%, after 2020 tumult

02/27/2023

by: Richard Scott

The most-billed health screenings covered under Medicare took a big dip in 2020 as the pandemic wrought a utilization depression, and, though some screenings are starting to come back, most of them hadn’t fully recovered a year later.

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