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Read the fine print to ready for community health integration services

09/25/2023

Delve into the details for community health integration (CHI) services to see if it is a good fit for your practice. CMS’ proposal to cover a new service has garnered a great deal of interest, but your practice should be familiar with the fine print for this proposed care management service before it commits additional time and resources to it.

CMS unveils second list of negotiated Part B drug prices

09/25/2023

by: Roy Edroso

A second list of 34 Part B drugs that will have their co-insurance lowered under the Inflation Reduction Act (IRA) has been announced by CMS.

Internalize NCCI basics: Defining edits and their roles in correct coding

09/25/2023

by: Denise Williams, COC, CHRI

One of the most important, and sometimes one of the most challenging, initiatives for providers is the National Correct Coding Initiative’s (NCCI) procedure-to-procedure (PTP) edits. It isn’t a hard concept to understand, but it can be challenging to apply because of practitioner documentation and operational aspects of the day-to-day processes.

HIPAA Q&A: Telehealth challenges, risk assessments, and more

09/25/2023

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

Part B News welcomes compliance expert Rebecca Herold, CDPSE, FIP, CISSP, CIPM, CIPP/US, CIPT, CISM, CISA, FLMI, CEO of Privacy & Security Brainiacs SaaS services, to answer a series of questions pertaining to critical HIPAA compliance areas, such as telehealth compliance and risk assessment.

Left side, right side: Providers go side-specific on injection, X-ray services

09/25/2023

by: Richard Scott

Coders turn to left- and right-side modifiers millions of times per year, and they are most likely to deploy the anatomic modifiers LT (Left side) and RT (Right side) following encounters with patients suffering from osteoarthritis.

Look to 6 Q&As to unravel the nuances of E/M coding, documentation

09/18/2023

by: Julia Kyles, CPC

Increase the E/M knowledge of coding staff and treating providers to ensure your claims are hitting the mark. You can bring these questions and answers to your next E/M training session. The first three questions address medical decision-making (MDM). The subsequent three questions tackle time-based coding.

Behavioral health in the PFS: CMS ignites its approach, adding providers, fees

09/18/2023

by: Roy Edroso

A closer look at the behavioral health changes proposed in the physician fee schedule rule released in July reveals more reimbursement opportunities for practices that are willing to expand their mental and behavioral health offerings but have not yet been able to figure out how to make it pay.

Telehealth, community health service overshadow pay cuts in PFS comments

09/18/2023

by: Julia Kyles, CPC

CMS received 17,614 comments on the proposed 2024 Medicare physician fee schedule, and with the public feedback period closing on Sept. 11, some of the most-discussed topics may surprise you.

October NCCI edit update focuses on revisions to the July update

09/18/2023

by: Julia Kyles, CPC

It won’t take long to train staff on the next National Correct Coding Initiative (NCCI) update. The procedure-to-procedure (PTP) edit update that will go into effect Oct. 1 deletes eight code pairs and revises 18 code pairs. There are no new edit pairs.

CMS previews projected 2024 payments for 52 new, newly active codes

09/18/2023

by: Julia Kyles, CPC

Take a look at proposed physician payments for new services: CMS included fees for 43 new CPT codes and seven HCPCS G codes in the proposed 2024 Medicare physician fee schedule.

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