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Compensation up, fees down? Signs point to a tight labor market

06/17/2024

Despite widespread complaints about physician reimbursement, two major practice surveys show physician compensation trending up substantially in 2023. While on the surface that’s good news, it may simply mean doctors are working harder, which may exacerbate another common complaint — physician burnout — and lead to other problems. But experts suggest ways to carry the volume more efficiently.

CMS adds more NCCI edits for caregiver training, prolonged service codes

06/17/2024

by: Julia Kyles, CPC

Don’t overlook the latest National Correct Coding Initiative (NCCI) update. If your practice misses the procedure-to-procedure (PTP) and medically unlikely edits (MUE) that go into effect July 1, you could spend the rest of the summer dealing with denials.

Are no-shows fees legal? Yes, in most cases, but you still may want to avoid

06/17/2024

by: Roy Edroso

Question: We charge patients $50 if they miss an appointment. I think it’s helped reduce no-shows. But we had one patient who missed an appointment and has refused to pay the fee. My boss wants to send it to collections, but I want to make sure first: Are we actually allowed to do that? (The patient is on Medicare.)

HIPAA Q&A: How to protect online tracking technology

06/17/2024

by: Rebecca Herold, CDPSE, FIP, CISSP, CIPM, CIPP/US, CIPT, CISM, CISA, FLMI

Question: How should HIPAA covered entities (CE) and business associates (BA) navigate the updated Office for Civil Rights (OCR) guidance on using online tracking technologies while ensuring PHI protection?

Survey shows Miss. tops for PCP, non-surgical specialist pay; D.C. lags

06/17/2024

by: Roy Edroso

The latest MGMA physician compensation report doesn’t just have financial figures for different practice types. It also looks at the top states and regions for compensation by different kinds of practitioner, some of which may be a surprise to you.

Under Section 1557 final rule, nondiscrimination mandates are coming soon

06/10/2024

by: Roy Edroso

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.

CMS clarifies signature requirements for MACs and other auditors

06/10/2024

by: Julia Kyles, CPC

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.

Improve trigger point injection coding with a specialist’s tips

06/10/2024

by: Julia Kyles, CPC

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

Expert: SDOH assessment needs follow-through beyond documentation

06/10/2024

by: Roy Edroso

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.

1 to 2 muscle trigger point injections fall 33% in 5 years

06/10/2024

by: Richard Scott

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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