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QPP 2022: Clinicians at small practices preferred group reporting

06/03/2024

Nearly 60% of small practices used the group reporting option to participate in the 2022 Quality Payment Program (QPP), and nearly 45% of small practices that participated via group reporting received the small practice bonus, according to Part B News analysis of the 2022 QPP Public Use File (PUF), which contains the most recent data on QPP participation.

CMS: In AWV, SDOH assessment can occur days before visit; append modifier

05/20/2024

by: Roy Edroso

A Change Request pertaining to the use of social determinants of health (SDOH) risk assessments during a Medicare annual wellness visit (AWV) stresses provider flexibility as to how they conduct the assessment. That should make it easier to handle the extra steps required.

Must you rehire suspended providers who get their license back? Look to contract.

05/20/2024

by: Roy Edroso

Question: I understand that when providers lose their medical licenses they can be fired or removed from a partnership agreement because not having a license prevents them from doing their job, i.e., treating patients and being paid for it. But sometimes these providers get their licenses back. Are there circumstances under which they must be rehired by their former practice?

Manage and engage remote staff with these strategies

05/20/2024

by: HCPro staff

Revenue cycle staff are among workers in many industries that are making the shift to remote work. Although there are benefits to working from home, some managers may find themselves struggling to adapt to the changes.

Alert: NIST publishes Cybersecurity Resource Guide for HIPAA security compliance

05/20/2024

by: Dom Nicastro

The National Institute of Standards and Technology (NIST) published NIST SP 800-66 Rev. 2 in February. You can turn to the publication to gain practical guidance and to safeguard health information and better understand the security concepts discussed in the HIPAA Security Rule.

G0136 joins select group of codes cleared for use with modifier 33

05/20/2024

by: Roy Edroso

A new billing policy requires that modifier 33 (Preventive services) appear with the social determinants of health (SDOH) assessment add-on code G0136 on all such claims submitted with annual wellness visits (AWV). This will mean a big change in that modifier’s utilization, which has mainly been limited to four codes (and overwhelmingly used for just one).

Use 4 team-based care scenarios to refresh your billing knowledge

05/13/2024

by: Julia Kyles, CPC

Medicare’s rules for incident-to and split/shared services give your practice the opportunity to gain extra revenue for a non-physician practitioner’s (NPP) work. But the chance to receive 100% of the physician payment when an NPP does all or some of the work for an encounter comes with the risk of significant pain if members of your practice, including physicians and NPPs, don’t follow the rules.

Ortho CPT coding Q&A: Know units of service, payer policies to capture pay

05/13/2024

by: Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC

Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, an independent medical coding education consultant, answers some of the many questions she receives pertaining to physician coding for CPT orthopedic services.

HIPAA Q&A: Vendor risk management, reproductive health care, and telehealth

05/13/2024

by: Julia Huddleston, CIPP/US, CIPM, CCSFP

In this issue, Part B News welcomes compliance expert Julia Huddleston, CIPP/US, CIPM, CCSFP, principal with Apgar & Associates, to answer a series of questions about HIPAA compliance areas, focusing on vendor risk management, reproductive rights and telehealth policies. The Q&A session is below.

CMS summary of Q1 2024 HCPCS Level II update includes 48 new codes

05/13/2024

by: Savannah Schmidt

CMS published a summary of its first quarter 2024 HCPCS Level II code update application decisions. There were 48 additions, two code definition revisions and seven discontinuations. The additional codes mostly consist of injection and skin substitute products.

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