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New health app rule would better protect users – and so can you

06/12/2023

Now is a good time to inform your patients that the health apps they use, which you may have prescribed or recommended, have different privacy protections than those afforded by HIPAA. However, take note of a new rule proposed by the Federal Trade Commission (FTC); if finalized, your patients will have a better chance of finding out when their data has been compromised, and malefactors will have specific penalties to worry about.

As gun laws loosen, prepare for possibly armed patients

06/12/2023

by: Roy Edroso

As gun laws grow more permissive across the country, consider the possibility that patients will show up to your office armed. Experts advise that you prepare with policies, intake procedures and a plan for untoward events.

PCP notification, not permission, is required for extended ESI treatments

06/12/2023

by: Julia Kyles, CPC

Question: We were told that we need to contact the patient’s primary care provider (PCP) before we perform epidural steroid injections (ESI) for Medicare patients. It’s hard to get the PCPs’ authorization for the injections. Where can we find proof that we need a PCP’s permission?

CMS releases HCPCS Level II codes for new products, live July 1

06/12/2023

by: Savannah Schmidt

CMS published its first quarter 2023 HCPCS Application Summaries and Coding Recommendations as part of its April 27 publication of MLN Connects.

After changes, FNA with ultrasound, tangential biopsy dominated

06/12/2023

by: Julia Kyles, CPC

The codes for fine needle aspiration (FNA) and biopsy of skin lesions received a major update in the 2019 CPT manual. The update revised FNA code 10021 to become a primary code for a new add-on code and replaced three outgoing codes with 16 new codes.

With the 3-day SNF rule back, look to build alliances to stay compliant

06/05/2023

by: Roy Edroso

Encouraging results from the use of waivers to the Medicare three-day skilled nursing facility (SNF) rule have prominent health care authorities, including some within the federal health care bureaucracy, challenging the rule’s necessity. But the rule is probably not going away soon, so providers whose patients make heavy use of skilled nursing should consider alliances that will exempt them for it.

Consider updating enrollment, weigh security risks if you offer telehealth from home

06/05/2023

by: Julia Kyles, CPC

Practitioners who perform telehealth from home (TFH) must update their enrollment before the end of the year. The COVID-19 public health emergency (PHE) waiver that allows physicians and non-physician practitioners (NPP) to bill for TFH under the practice’s address will expire Dec. 31, 2023.

Crack the modifier 25 code: Clear confusion, review scenarios

06/05/2023

by: Courtney Crozier, MA, RHIA, CCS, CDIP

The AMA published additional guidance for modifier 25 (Significant, separately identifiable E/M service by the same physician or other qualified healthcare professional on the same day of the procedure or other service) in its recent publication of CPT Assistant, released March 2023.

Sanctions vs. COVID non-compliant docs don’t automatically lift with end of PHE

06/05/2023

by: Roy Edroso

Question: One of our former physicians had his license pulled for passing “COVID misinformation” during the public health emergency (PHE). Now that the PHE is over, what are his chances of getting his license back?

CMS launches application period for ’24 Shared Savings ACO program

06/05/2023

by: Richard Scott

Mark your calendar if you’re interested in entering a value-based care arrangement through the Medicare Shared Savings Program, the federal government's largest accountable care organization (ACO) network. The deadline to apply for 2024 is June 15.

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