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CMS finalizes mandatory radiation oncology model launching in 2021
10/12/2020
by: Valerie Rinkle, MPA, CHRI
On Sept. 18, the Centers for Medicare and Medicaid Innovation (CMMI) published the final Radiation Oncology Model (ROM) rule. This demonstration project is a mandatory model that includes approximately 30% of outpatient radiation therapy episodes nationally furnished by freestanding and hospital-based radiation oncology providers.
When a doctor dies, mind patient records and act fast if heirs are unlicensed
10/12/2020
by: Roy Edroso
Question: If one of our physicians dies, what are we obliged to do besides notify the patients and invite them to transfer care to one of our other doctors?
How to report shared visit services using the 2021 E/M guidelines
10/12/2020
by: Sarah Gould
Question: During an office visit, a nurse reviews the patient’s medical history and a physician performs an examination in the presence of the nurse. If you adhere to the 2021 E/M guidelines and use time as the controlling factor for code selection, can you report one E/M code for these shared services?
AMA releases two COVID-19 and flu combo codes
10/12/2020
by: Richard Scott
You can add two new codes to your COVID-19 response kit, with the added bonus that the codes are applicable for seasonal flu testing as well.
Medicare Advantage enrollment balloons 44% in six years
10/12/2020
by: Roy Edroso
It’s still a traditional-Medicare world, but if trends continue, it won’t be for long.
As growth of NPs and PAs accelerates, expect practice duties to rise too
10/05/2020
by: Roy Edroso
The role of nurse practitioners (NP) and physician assistants (PA) is growing — but so is the shortage of physician health care providers. This is expected to lead to an expansion in the practice capabilities of these providers, and you’re likely to see some changes in their relationship with physicians.
Ahead of Oct. 1 start, master 2021 ICD-10-CM coding for nervous system conditions
10/05/2020
by: Sarah Gould
The fiscal year (FY) 2021 update to the ICD-10-CM code set includes 26 new codes for nervous system conditions, such as cerebellar ataxia, Dravet syndrome and cerebral spinal fluid (CSF) leaks.
Asymptomatic but wants a COVID test? Press for medical necessity in notes, use Z-code
10/05/2020
by: Roy Edroso
Question: My patient is visiting aged relatives and wants a COVID test before she goes to reduce the chance of infecting them. How should I code this? And will Medicare deny the charge for lack of medical necessity, as my patient lacks any symptoms?
In recent years, nurse practitioners gobble up shares of E/M office visit claims
10/05/2020
by: Richard Scott
The number of office E/M codes that nurse practitioners (NP) are reporting under Medicare Part B has been on a significant upswing in recent years. Total claims for their most-billed office code, 99214, are up 114% from 2014 to 2018.
Flu season plus COVID-19 ‘twindemic’ could get rough; push shots early and hard
09/28/2020
by: Roy Edroso
COVID-19 complicates your flu season immunization picture, but experts say it may become an opening that not only gets more patients interested in having their shots, but also gets them to receive other needed care.
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