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Overbooking underperforming? 5 tips to unstick your schedule

06/26/2023

Overbooking patient encounters is an open secret in practice management. But it can be tricky to get the mix of expected no-shows and available provider slots right. Experts suggest some tech fixes, and also alternatives that may, at least to some extent, make the balancing act easier.

Latest quality payment report hints at registries’ growing popularity

06/26/2023

by: Julia Kyles, CPC

Usage patterns show that providers favor all-in-one electronic methods to submit their quality payment program (QPP) data.

Discover 395 new ICD-10-CM codes taking effect in October, plus revisions, deletions

06/26/2023

by: Julia Kyles, CPC and Laura Evans, CPC

Prepare for several hundred new ICD-10-CM codes now finalized to take effect Oct. 1. On June 16, CMS announced the addition of 395 new diagnosis codes, 25 deletions to the ICD-10-CM code set and 13 revisions. In addition, there are hundreds of changes to tabular instructions added in the addenda for the FY 2024 code set.

SCOTUS False Claims ruling could mean fewer future whistleblowers

06/26/2023

by: Roy Edroso

A recent Supreme Court ruling on the False Claims Act (FCA) argues that the U.S. government can withdraw from a qui tam case even when it has decided not to enter it — which may winnow the number of whistleblower cases going to trial in the future.

Calling patient with test results is not a telephone E/M service

06/26/2023

by: Julia Kyles, CPC

Question: Our physicians and nurse practitioners (NP) prefer to call patients with their test results rather than waiting until the next visit or delegating the task to a member of clinical staff. Most of the calls last at least five minutes, but some can take much longer. Our providers have said we should bill the calls as telephone E/M services (99441-99443) when the patient is a Medicare beneficiary or has a payer that covers telephone E/M. Is that permissible?

Reminder: Modifier KX is the cure for gender-based denials

06/26/2023

by: Julia Kyles, CPC

Practices that treat transgender, intersex, and gender-expansive patients take note: When a gender-specific procedure or diagnosis code doesn’t match the patient’s reported sex, coders should append modifier KX (Requirements specified in the medical policy have been met) to the claim.

Providers must specify the risk for decision regarding surgery

06/26/2023

by: Julia Kyles, CPC

All procedures come with inherent risks, but you can’t automatically count those risks toward medical decision-making (MDM) for an E/M visit. The treating provider must identify the specific risk of a minor surgery or a major elective surgery.

Want a J-1 visa doctor? Prepare to work (and pay) for it

06/26/2023

by: Roy Edroso

Question: We’re in a HPSA [health professional shortage area] and have trouble finding appropriate doctors. I’m told there’s a government program that allows qualified foreign doctors who want to work in the U.S. to do so if they commit to working in a HPSA. How do we get in on that?

QPP report shows MIPS sagging, Advanced APMs lifting

06/26/2023

by: Roy Edroso

The latest Quality Payment Program (QPP) Experience Report, released on June 12, showed the number of eligible providers in MIPS declined, though Advanced APM participants rose. And as usual nearly everyone escaped a penalty, though bonuses remain low.

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