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Final ICD-10-CM update for 2019 includes 38 more changes than proposed
06/18/2018
by: DecisionHealth staff
Providers will have a total of 473 code changes beginning Oct. 1, including 279 new codes, 143 revised codes and 51 deactivated codes, according to the final list of changes issued June 11 by the Centers for Disease Control and Prevention.
Obesity-counseling claims keep rising but high denial rates stick
06/18/2018
by: Richard Scott
Practices around the country are providing a greater number of obesity-counseling services, as the 307,000 claims of G0447 (Face-to-face behavioral counseling for obesity, 15 minutes) in 2016 indicate.
7 tips to correctly tap into time to report new, existing prolonged care codes
06/11/2018
by: Richard Scott
Your E/M office coding can get tricky when you base your level of service on time spent with the patient, but understanding when to use time thresholds, such as during counseling-based visits, will give your coding a boost — especially when tacking on prolonged services to your encounter codes.
Patient unlikely to get AWVs on MA home visits – but check
06/11/2018
by: Roy Edroso

Question: One of our patients’ Medicare Advantage plans is offering its members home visits by a nurse. The nurse performs many of the same services that patients receive with they see their primary care physician for an annual wellness visit. Do I have to worry that they’ll do annual wellness visits (AWV) on my patients without telling me about it and cause confusion and lost charges when I try to bill it?

7 tips to correctly tap into time to report new, existing prolonged care codes
06/11/2018
by: Richard Scott

Your E/M office coding can get tricky when you base your level of service on time spent with the patient, but understanding when to use time thresholds, such as during counseling-based visits, will give your coding a boost — especially when tacking on prolonged services to your encounter codes.

Comprehensive Primary Care program misses spending mark but practices love it
06/11/2018
by: Richard Scott

The Comprehensive Primary Care (CPC) initiative failed to substantially bend the Medicare spending curve, according to a new report. But leaders on the ground remain bullish about the value-based program, which they say has positioned their practices for long-term success.

Orthopedic practice scores a win in challenge to CCI code pairs
06/11/2018
by: Laura Evans

It doesn’t cost anything to ask for a correction if you find a possible Medicare coding error. And, as a Syracuse orthopedic practice discovered, you may end up reversing a troublesome code restriction that has been in effect for more than a decade.

Use higher pay, openness to outside experience to recruit non-clinical employees
06/11/2018
by: Roy Edroso

Recent evidence suggests good non-clinical practice employees — from receptionists, billers and coders to managers and department heads — have gotten harder to hire and keep and that you’ll have to spend money and look in new directions to do so.

AWV, IPPE denials stay high; initial AWV use, after a burst, falls
06/11/2018
by: Roy Edroso

Providers have seen no big break in the long tradition of high denials for both initial (G0438) and subsequent (G0439) annual wellness visits (AWVs), nor for the Welcome to Medicare visit (G0402; also known at the Initial Preventive Physical Examination or IPPE).

Medicare diabetes program starts slow, and pay hard to get — but may still be worth it
06/04/2018
by: Roy Edroso
Getting your pre-diabetic patients involved with the new Medicare Diabetes Prevention Program (MDPP) may be worth your while even if you have to foot the bill temporarily.
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