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Hear me out: How to code bone conducting hearing devices in CPT

07/10/2023

Hearing loss affects millions of people worldwide, and conventional hearing aids have been the standard solution for decades. However, a surgical osseointegrated bone prosthesis has emerged as a popular alternative for patients who cannot adjust to traditional hearing aids. This type of hearing device bypasses the middle ear and treats hearing loss through a process called “osseointegration.”

OIG audit spots potential coding pitfalls for psychotherapy services

07/10/2023

by: Savannah Schmidt

The Office of Inspector General (OIG) recently released the results of an audit of Medicare billing requirements for psychotherapy services submitted from March 2020 through February 2021 as providers adapted to changes introduced as a result of the COVID-19 public health emergency (PHE).

Practices turned to telehealth for 40% of psych visits after CMS waivers

07/10/2023

by: Richard Scott

Auditors are keying in on psychotherapy services delivered via telehealth, and Medicare claims show that they will have a massive trove of data to investigate. In 2021, as the COVID crisis continued to shutter offices, providers routinely turned to telehealth to deliver behavioral health care to patients after CMS granted waivers, capturing some 40% of visits on the most-used services.

Language translation apps may leave you open to liability; use wisely

07/03/2023

by: Roy Edroso

Are you using, or thinking about using, a translation app to fulfill your responsibilities to patients who are not fluent in English? You may have seen or heard about the ease with which available apps can translate conversation on the fly and wondered whether that would work for the office as well.

Know what to do when a prescribed device is subject of FDA warning letter

07/03/2023

by: Julia Kyles, CPC

The Food & Drug Administration (FDA) recently issued a warning letter to iRhythm Technologies about the Zio AT, one of the manufacturer’s mobile cardiac monitoring devices. However, an FDA warning letter is cause for alertness, not alarm, on the part of providers.

ICD-10-CM update ushers in critical changes to tabular addenda

07/03/2023

Take note of hundreds of updates to the tabular addenda that serves as an instruction guide to the ICD-10-CM code set (PBN 6/26/23). CMS announced the changes as part of the code set update on June 16. All changes, including new, revised and deleted codes and the tabular addenda revisions, take effect Oct. 1.

CMS issues new edits for drug tests, nerve blocks

07/03/2023

by: Julia Kyles, CPC

Take note if your practice bills presumptive and definitive drug tests. Effective July 1, a new procedure-to-procedure (PTP) edit will bundle definitive drug tests into presumptive drug tests. CMS also set a modifier indicator of 0 for the edit, which means you won’t be able to break the pair with a modifier.

Service increase: How to report a shoulder arthroplasty with modifier 22

07/03/2023

by: Savannah Schmidt

Question: What intraoperative work would warrant reporting a reverse shoulder arthroplasty with physician modifier 22 (Increased procedural service)?

Count MDM risk level based on viable treatment options discussed at encounter

07/03/2023

by: Laura Evans, CPC

Question: When selecting the level of risk to code based on medical decision-making (MDM), the 2023 E/M guidelines state that you can count the risk of treatment options that were discussed but ultimately not chosen. We are wondering how much discussion must be documented in order to count toward risk? For example, our providers will list the treatment options and then document what was recommended and decided...

Physicians score EHR systems highly, but many ding chart time

07/03/2023

by: Julia Kyles, CPC

More than 60% of physicians are “very” or “somewhat” satisfied with their electronic health record (EHR) systems and described documenting clinical care – whether they use a paper or EHR system – as “very” or “somewhat” easy, according to analysis of the last three National EHR Surveys, which contain data for 2018, 2019 and 2021.

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