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After deadly drop-down case: Fail-safe your EHR medication orders

07/17/2023

A recent drop-down error that, authorities suggest, contributed to a patient’s death is a reminder to keep up with electronic health record (EHR) safety improvements from your vendor, and to make sure everyone at your practice is empowered to speak up when something seems amiss.

CMS issues surprise changes to post-PHE enrollment, frequency limit waivers

07/17/2023

by: Julia Kyles, CPC

The COVID-19 public health emergency (PHE) ended at 11:59 p.m., May 11. CMS and other Health & Human Services (HHS) agencies left several waivers in place. But that wasn’t the end of the PHE story.

Watch for 6 updates hiding in the new ICD-10-CM guidelines

07/17/2023

by: Julia Kyles, CPC

Watch for invisible changes when you prepare for the new ICD-10-CM guidelines. The Centers for Disease Control and Prevention (CDC) published the ICD-10-CM Official Guidelines for Coding and Reporting FY 2024 on July 5. The new guidelines will go into effect Oct. 1 and replace the guidelines that went into effect April 1.

AMA joins others in downgrading BMI; prepare for questions

07/17/2023

by: Roy Edroso

The AMA is the latest and best-known authority to suggest body mass index (BMI) may not be a relevant measure of health for many patients. Whether or not this means it’s time to reconsider its use, it’s certainly time to prepare to answer patient questions about it.

Bundling policies likely to block pay for 99000

07/17/2023

by: Julia Kyles, CPC

Question: Our practice performs and bills for simple tests in our CLIA-waived lab. For more complex tests, the patient comes to the practice, we collect the specimen and send it to an outside lab. In both cases, storing and handling specimens takes extra time and expense. Can we bill 99000 (Handling and/or conveyance of specimen for transfer from the office to a laboratory)?

CMS releases revised guidance for Medicare drug price negotiation program

07/17/2023

by: Dom Nicastro

On June 30, CMS published Revised Guidance regarding the Medicare Drug Price Negotiation Program in which CMS will negotiate with drug manufacturers to set maximum fair prices for certain high-expenditure, single-source drugs without generic or biosimilar alternatives.

Claims with OR-return modifier 78 drop 25% in one year

07/17/2023

by: Roy Edroso

The years-long decline in claims with modifier 78 (Unplanned return to the operating room by the same physician following initial procedure for a related procedure during the postoperative period) was accelerated by the pandemic in 2020. This downward trend appears to have continued in 2021: The total number of claims made with 78 dropped precipitously, from 87,826 in 2020 to 65,857 in 2021, a decline of 25%.

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