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The finalization of the Section 1557 rule from HHS’ Office for Civil Rights (OCR) means that practices will have to take practical steps — including training staff and designating a 1557 “coordinator” — with urgency, as the rule has an effective date of July 5 and tight deadlines.
Make sure staff who handle audit requests understand when a missing signature should — or should not — trigger an automatic denial of your claims or prior authorization requests. Recent guidance from CMS clarifies how auditors should proceed when a medical record lacks a signature. CMS also removed its famous signature chart from its guidance.

Boost your staff’s trigger point injection coding (20552-20553) knowledge by adding clinical trigger point facts to your next training session.

CMS continues to expand its use of social determinants of health (SDOH) in Medicare. Recently the agency made a manual change making an SDOH assessment a payable add-on service with the Medicare annual wellness visit (AWV). If the provider taking the assessment finds the patient has social issues that should be addressed, you have an obligation to go beyond documenting it.
The rates of administering trigger point injections (TPI) have dropped dramatically in recent years, and providers have witnessed an associated revenue shortfall for the two primary TPI codes used for pain management.


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