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Nurse practitioners reap massive pay gains after E/M fee surge

01/23/2023

Following the pandemic-induced sag in patient encounters in 2020, nurse practitioners nearly returned to pre-COVID levels in 2021 — and with federal dollars buoying E/M services, their payments roared to new heights.

Tap, tap: See better patient results, and provider scores, with SMS outreach

01/16/2023

by: Roy Edroso

A recent study shows automated text messaging to transitional care management (TCM) patients was tied to reduced readmission to the hospital and ED, suggesting that these SMS interventions can go beyond patient-provider convenience and actually improve patient care. They may also boost provider performance ratings — in payer programs and at review websites.

CMS posts new +2.4% conversion factor for 2023 Medicare fees

01/16/2023

by: Richard Scott

On the heels of the omnibus spending bill that President Biden signed into law Dec. 29, CMS has taken up one of its imperatives to scale down the reduction in Medicare payments. The agency posted a revised conversion factor of $33.8872, replacing the $33.0607 amount originally released with the final 2023 Medicare physician fee schedule.

CMS adds 35 codes to the Stark list of designated health services

01/16/2023

by: Julia Kyles, CPC

Remember to add the latest designated health service (DHS) codes to your practice’s compliance plan. For the first time CMS did not release the updated list in the final Medicare physician fee schedule.

Master ICD-10-CM coding for various types of diabetes mellitus

01/16/2023

by: Shelley C. Safian

Diabetes mellitus is an insidious condition, as it invades the body in many different ways. This chronic disease causes elevated levels of glucose in the blood. If left untreated, this systemic condition leads to serious damage to multiple body systems. Ensure you’re capturing your patients’ details correctly to depict accurate coding.

E/M codes in ED top list of independent dispute resolution services

01/16/2023

by: Julia Kyles, CPC

Emergency department visits (99281-99288) topped the list of services that triggered a request for an independent dispute resolution (IDR) during the second and third quarters of 2022, according to a report on the newfangled payment dispute process.

MDM update includes 3 new problems addressed, 1 new risk category

01/09/2023

by: Julia Kyles, CPC

Reinforce your understanding of the new medical decision-making (MDM) requirements with tips from a physician who oversaw the E/M guideline updates.

Study the new problems addressed definitions

01/09/2023

by: Julia Kyles, CPC

You wouldn’t report a code if you didn’t understand its long descriptor. The same principle applies to the definitions for coding based on medical decision-making (MDM). The 2023 E/M update includes three additions to the number and complexity of problems addressed at the encounter element. Keep these definitions on hand until they’re fixed in your memory.

CCI version 29.0 aligns billing limits with 2023 coding adds, losses

01/09/2023

by: Richard Scott

You’ll find thousands of added code pairs, and even more deleted code pairs, as part of the latest Correct Coding Initiative (CCI) quarterly edits. Effective Jan. 1, the version 29.0 changes mark a year-end coding clean-up that resets coding pairs across all categories of services.

Omnibus spending bill dents Medicare cuts, extends telehealth flex

01/09/2023

by: Roy Edroso

The final version of Congress’ year-end appropriations bill for 2023, which President Biden signed into law Dec. 29, takes a bite out of the daunting 4.5% conversion factor (CF) cut to Medicare providers’ reimbursement that had been expected. Instead, the CF will drop by 2% for CY 2023.

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