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MAOs more motivated to audit; 4 tips will help your in-person process

12/18/2023

As CMS rolls out new standards for audits of Medicare Advantage organizations (MAO), providers who contract with those organizations may expect them to audit more aggressively — and also worry that the MAOs could be looking to stick them with the responsibility for government takebacks. Experts advise that practices cooperate as the regulations and their contracts require; but make sure you know your rights and take steps to protect them.

New NCCI edits skip 2024-effective codes, tie up loose ends for 2023

12/18/2023

by: Julia Kyles, CPC

Despite what you might think at first glance, the latest National Correct Coding Initiative (NCCI) update isn’t missing any codes. CMS did not include new procedure-to-procedure (PTP) edits or medically unlikely edits (MUE) for codes that will go into effect in 2024 in the Jan. 1, 2024, NCCI update. That means your practice can focus on implementing the new codes and guidelines without worrying about bundling edits.

Medicare adds guidance for appeals, revises language in 2024 NCCI manual

12/18/2023

by: Julia Kyles, CPC

Remember to study the 2024 Medicare National Correct Coding Initiative (NCCI) Policy Manual while you prepare to code in the new year. The new manual, along with the new procedure-to-procedure (PTP) and medically unlikely edits (MUE), were published Dec. 1, and will go into effect Jan. 1, 2024.

Be proactive about discrimination support – or risk liability

12/18/2023

by: Roy Edroso

If an employee has a discrimination issue, whether it’s reported or unreported, don’t try to “wing it.” Instead, have a process in place that makes sure both the employee and the practice are protected — and invite employees to use it.

3 Q&As: Manage coding errors, burnish documentation, code from reports

12/18/2023

by: Julia Kyles, CPC

The following series of questions and answers deliver key coding and documentation guidance on various sce-narios you may encounter in your day-to-day operations. All Q&As took place during the Advanced Specialty Coding Summit — Anesthesia, a DecisionHealth virtual event that took place in November.

5-minute interprofessional consult code maintains strong growth

12/18/2023

by: Richard Scott

Most of the interprofessional consultation services that saw a spike in claims during the initial COVID wave returned to lower utilization, except for a glaring outlier: the most-reported interprofessional consult code 99451 continues its surging growth trajectory.

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