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Loper Bright ruling brings new challenges to health care rules: Experts

08/05/2024

A Supreme Court decision has major repercussions for federal regulations, including the final rules on which health care providers rely. Experts say that even bedrock Medicare payment and coverage rules may now be vulnerable to challenge, but other rules with more limited impact are likely to be attacked first.

CMS considers extra payment for some post-operative care work

08/05/2024

by: Julia Kyles, CPC

Practitioners who provide post-operative care for patients without a formal transfer of care from the surgeon could receive a few extra dollars for their trouble if CMS finalizes a proposed add-on code (PBN 7/29/24). But CMS envisions a variety of limits for the new complexity of care code, including who can perform it, where it can be performed and a time limit for performing it.

Don’t let patient disputes escalate; plan to protect yourself

08/05/2024

by: Roy Edroso

Minor patient disputes that do not rise to the level of malpractice or negligence can still be troublesome for a practice, especially if poor handling lets them get out of hand. Have an action plan in place to address them when they arise to avoid seeming brusque, overpromising or encouraging a more negative reaction.

The next ICD-10-CM code set is expansion packed

08/05/2024

by: Julia Kyles, CPC

Alert your team to new diagnosis codes that will require more detail at the documentation and coding level. The FY2025 ICD-10-CM code set deletes a variety of more general diagnosis codes and replaces them with dozens of specific codes.

Train your team with the complete ICD-10-CM code set

08/05/2024

by: Julia Kyles, CPC

Prepare members of your treatment and coding teams for changes to the diagnosis code set that will go into effect Oct. 1, 2024. Download and share the Excel file that contains five spreadsheets.

Losers outpace winners in 2025 PFS payment-adjustment chart

08/05/2024

by: Roy Edroso

The grim conversion factor news in the proposed 2025 Medicare physician fee schedule only gets worse when you look at how it plays out in specific physician payments. According to the supplemental files published with the rule, only 173 out of 4,146 codes would see a positive adjustment from 2024.

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