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5 scenarios when you shouldn't report modifier 24 after a surgery

06/13/2016

Avoid common pitfalls when you code for services that occur during a global surgical period by knowing when to use modifier 24 – and, just as importantly, knowing when to avoid using it, such as the event of a wound complication.

Conduct a mid-year check to make sure you’re on target for PQRS success

06/13/2016

by: Julia Kyles

As the year’s mid-point approaches, you need to be certain your quality plan is on track. If you don’t, the best-case scenario for practices that let their quality efforts flag is a mad, and possibly expensive, scramble to report through a registry.

Labor ups minimum salary level for overtime exemption

06/13/2016

by: Josh Poltilove

In the wake of a U.S. Department of Labor final rule released May 18, practices must examine exempt employees’ current salaries to figure out how many people on their workforce will be above the salary threshold when the rule takes effect Dec. 1.

Prepare for Zika encounters with a coding plan, staff education

06/13/2016

by: Richard Scott

While the current status of the Zika virus is more potential than pandemic, the smart move is to plan ahead and get ready to code for Zika-related encounters and educate your staff so you’re prepared to quell any patient fears.

Patient acting up? Don’t hesitate — call the cops to protect your staff

06/13/2016

by: Roy Edroso

Question: At what point should I call the police on an unruly patient?

Denial rates of common allergy codes change — but remain tough to get paid

06/13/2016

by: Roy Edroso

New allergy skin tests codes added in 2013 haven’t worked out too well for providers. The most recently available Medicare data on those CPT codes show high denial rates for the new codes, continuing a trend with allergy skin test codes.

CMS drops two-midnight rule payment cut; short stays likely to stay under scrutiny

06/06/2016

by: Scott Kraft

CMS has abandoned plans to cut inpatient hospital payments by 0.2% to pay for its “two-midnight rule” following a partial victory by the American Hospital Association in a lawsuit against the agency.

OCR’s sample grievance policy gives your practice a model it can use

06/06/2016

by: Julia Kyles

Practices with more than 14 employees must give patients the means to lodge complaints about discrimination and appoint at least one staff member who will be responsible for investigating and responding in a timely manner. Providers with a procedure in place should review their grievance procedure to make sure they’re in compliance.

Use a good plan, common sense to meet new patient language standards

06/06/2016

by: Roy Edroso

The ways in which the new nondiscrimination rule increases your responsibilities to limited-English-speaking patients aren’t entirely clear, experts tell Part B News — but you should use common sense and stand ready to meet a few specific requirements.

Small practices: Resources, tips to avoid potentially painful impact of MIPS

06/06/2016

by: Richard Scott

Small practices should brace for a rocky landing when the merit-based incentive payment system (MIPS) docks in 2017, as more than half of all solo providers and groups with fewer than 25 clinicians will incur a penalty, CMS expects. Or will they?

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