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Benchmark of the Week
06/21/2021
by: Roy Edroso
CMS has been pushing for wider use of its behavioral health codes, which you can see in the big push to get providers to use 99483 (Assessment of and care planning for a patient with cognitive impairment). The uptake has been on the slow side, but signals are flashing that the pace may pick up over time.
06/14/2021
Watch a recent addition to the HHS Office of Inspector General’s (OIG) Work Plan: It may have implications for practices that frequently report a procedure and an E/M visit during the same patient encounter.
06/07/2021
You might expect that the most-used codes billed under place of service (POS) 11 (Office) would closely mirror the most-reported codes overall. But aside from the two most popular E/M codes, they don’t much overlap.
05/24/2021
Medical practices returned reams of money on leading services that they reported with modifier 26 (Professional component), including a spate of X-ray codes, tissue exams and other testing codes.
05/17/2021
In a recent five-year span, the use of inpatient codes declined at a faster rate than they had in previous years, and denial rates dropped even more quickly.
05/10/2021
Mastering the use of modifiers can be lucrative business for physician practices, as the latest modifier 59 (Distinct procedural service) utilization numbers reveal. In 2019, providers pulled in nearly $1.5 billion from Medicare on thousands of codes paired with the modifier.
05/03/2021
Though CMS estimates that one in five Americans aged 65 years and over has either type 1 or type 2 diabetes, Medicare’s codes for services that help diabetic patients cope with their disease have not performed very strongly in recent years, and are beset with high denial rates.
04/26/2021
Providers pulled in nearly $1.5 billion in payments for subsequent nursing facility encounters in 2019, continuing a strong rate of growth largely fueled by an uptick in nurse practitioner visits.
04/19/2021
While it’s not used as often as other care management services in Medicare Part B, transitional care management (TCM) has witnessed steady growth overall, and its denial rates remain low. But there are some provider types claiming from some facility types that don’t do so well with them.
04/12/2021
Medical practices showed a tepid response to the launch of a series of interprofessional consultations in 2019, the first year that CMS approved the codes for reimbursement.

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