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2024 specialty impact: Endocrinology, family practice up, dozens down

11/13/2023

The final specialty-based fee projections look a lot like the ones CMS proposed several months ago. Setting the threshold at positive or negative 2%, a total of 10 specialties are on pace to see fee gains in 2024, while 18 are in the red.

Young physicians seek money. Don’t have much? Try equity, loan plans.

11/06/2023

by: Roy Edroso

New findings show that young physicians, laboring under huge medical school debt, are attracted to the jobs that promise the most generous compensation. If you want those providers and you can’t compete on price, however, there are other ways to get their attention.

Coding veterans offer praise, express concern, about new split or shared guidelines

11/06/2023

by: Julia Kyles, CPC

Coding and compliance veterans saw a nod to best documentation practices, a possible return to attesta- tions and potential billing confusion after their initial read of the 2024 CPT manual’s revised split or shared guidelines, released in early October.

E/M coding scenario: How a dyspnea case meets a Level 4 visit

11/06/2023

by: DecisionHealth staff

Under the current E/M guidelines for level-based services, previously vital components of code level selection — namely, the history and exam components — no longer factor into the level of decision-making. Instead, determining a level of service comes down to one of two components: Medical decision-making (MDM) or time.

Understand the 2024 ICD-10-CM cardio coding guideline update

11/06/2023

by: Savannah Schmidt

Question: Do the 2024 ICD-10-CM guidelines include any changes related to cardiovascular condition reporting?

Know when to report SDOH with E/M codes based on MDM

11/06/2023

by: Savannah Schmidt

Question: Are coders required to report a social determinants of health (SDOH) ICD-10-CM code when a CPT code for an E/M service level is based on medical decision-making (MDM)?

With lone exception, hospital visits, and payments, continued descent

11/06/2023

by: Richard Scott

All but one code in the series of six initial (99221-99223) and subsequent (99231-99233) hospital care encounter codes saw a claims drop-off in the three-year period from 2020-2022, and providers saw a decline in total payments over the same span.

For space rental deals, safe harbor not necessary – but a good idea

10/30/2023

by: Roy Edroso

A $6.5 million settlement in a fraud case based on physician practice space rental serves as a warning that such arrangements can drift into anti-kickback statute (AKS) non-compliance — and from there to big trouble.

2024 neurostimulator update: Make sure your practice is wired for success

10/30/2023

by: Julia Kyles, CPC

Your 2024 CPT manual contains seven new codes related to integrated peripheral and spinal neurostimulator systems, revisions to four codes and new guidelines that clarify when you should use permanent procedure codes from the nervous system chapter and when you should report a temporary Category III code.

Review CPT wound care treatment methods and procedures

10/30/2023

by: Savannah Schmidt

Reporting wound care can be as complex and arduous as the methods themselves. Ensure you pay close attention to the many policies and procedures that coders must be aware of to account for the process and products accurately.

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