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Physicians may have a new tool at their disposal to find the lowest-priced drugs for patients should a proposed rule from CMS take effect as planned. The proposed rule, released Nov. 26, would require Part D plans to adopt a Real Time Benefit Tool that can alert providers to the current price of drugs available under a patient's coverage terms.
CMS hit the brakes on making imminent changes to the oft-used E/M code set that’s tied to billions of dollars in medical practice revenue. Streamlined payment rates are off the table for 2019, as are vast documentation revisions, according to the 2,378-page final 2019 Medicare physician fee schedule released Nov. 1. Once you’ve read through our detailed breaking news, take our quick, confidential survey to share your opinion.
By this time next week, we should know the answer to a question that has been on the minds of health care stakeholders since July:
 
What in the world will CMS do with E/M visits?
It may sound counterintuitive, but two patients who are attributed the same diagnosis during a patient encounter can have wildly divergent risk-adjustment coding scores.
When coding under a risk-adjustment paradigm, capturing the full range of a patient’s chronic conditions takes on elevated importance. That’s because your payments, and ultimately your coding compliance, may be impacted.

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