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Practices see revenue gains for obesity-counseling code G0447

04/10/2017

Payments for obesity-counseling code G0447 (Face-to-face behavioral counseling for obesity, 15 minutes) continue to climb as the service gains traction among medical practices.

MAC covering 10 states gets tougher on E/M exam requirements

04/03/2017

by: Richard Scott

Practices will find it more challenging to reach a higher-level E/M because of one Medicare administrative contractor’s (MAC’s) changes to documentation requirements for detailed exams.

Obamacare replacement plan fizzles; momentum stalls on comprehensive change

04/03/2017

by: Richard Scott

You can continue to conduct business as usual with patients on health exchanges after the American Health Care Act (AHCA) went down without a vote. Facing opposition from both moderate Republicans and the more conservative House Freedom Caucus, the bill that would have repealed the Affordable Care Act...

Save time by letting patients set pre-visit agenda through EHR, patient portals

04/03/2017

by: Richard Scott

Give your patients the opportunity to set an agenda ahead of their office visits and you may witness improved patient engagement and clinical outcomes — while also saving yourself a significant amount of administrative time.

Change to claims-processing manual expands ACP copay advantage to OPPS

04/03/2017

by: Roy Edroso

CMS has made performing advance care planning (ACP) and getting paid for it easier in more situations by expanding a key benefit to the hospital outpatient prospective payment system (OPPS).

Billing for phone, internet services a stretch — but some opportunities exist

04/03/2017

by: Roy Edroso

Question: Can we get paid for 99444 (Online evaluation and management service provided by a physician or other qualified health care professional) or 99441-99442 (Telephone evaluation and management service by a physician or other qualified health care professional)?

Rates at MAC making big E/M changes similar to rest of U.S.

04/03/2017

by: Roy Edroso

You may wonder whether National Government Services (NGS) has a specific reason for making it more challenging to reach higher-level E/M requirements with new exam specifications, while other Medicare administrative contractors (MACs) have not. Data suggests it doesn’t have to do with any unusual patterns in E/M billing denial rates in the 10 states NGS covers versus the rest of the country.

ACA repeal bill gets changes; HHS cut 18%; EPM programs delayed [UPDATED]

03/27/2017

by: Roy Edroso

Last-minute changes to the Obamacare replacement bill, a huge budget cut for HHS and a three-month delay of new episode payment models (EPMs) are among the top health care stories from Washington.

New data on X modifiers show they sometimes beat modifier 59 — but be careful

03/27/2017

by: Roy Edroso

Despite a lack of recent official guidance on the X modifiers that were developed to provide more specifics than modifier 59 (Distinct procedural service), in some cases Medicare providers have seen lower denial rates using the new modifiers, according to CMS data obtained by Part B News.

Confusion about new moderate sedation codes agitates carriers and providers

03/27/2017

by: Julia Kyles, CPC

Questions about how to calculate time and denials for an add-on code have left coders and Medicare administrative contractors feeling anything but sedate about the new moderate sedation codes (99151-99157). Here are some quick tips to restore calm.

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