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CMS’ health equity and primary care missions combine in a new accountable care organization (ACO) demonstration model offering quarter-million-dollar upfront payment to “low revenue” PCPs.
Sections of the Affordable Care Act (ACA) amend the Social Security Act by requiring changes in payment and patient responsibility for deductible and coinsurance/copayments for certain preventive services, such as bone mass measurement, diabetes screening and mammography screenings.
Much discussion of artificial intelligence (AI) in health care focuses on the readiness, or lack thereof, of clinical applications. But even if you’re using only the most basic AI tools, such as scribing applications, you still need to be careful about data security, integrity and privacy — and about the contract terms that allow the vendor to use your data.
Get ready for another update to your local coverage determination (LCD) for facet joint interventions. Medicare administrative contractors (MAC) are teaming up again to clarify their uniform LCD for facet joint nerve blocks (64490-64491 and 64493-64494) and radiofrequency ablation (RFA) (64633-64636).
For the second year running, providers turned to modifier 59 (Distinct procedural service) most often when performing a lesion-destruction service, and denials held steady for codes 17003 and 17000. But keep an eye on a duo of lab codes: the denial rates on 87798 and 87481 shot up significantly in 2022.


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