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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.

Medicare Advantage is gaining ground among patients and practices are well-advised to investigate those contracts, as we reported on October 16, . Donald Rebhun, M.D., co-chair of the Quality and Performance Committee for the California Association of Physician Groups (CAPG) and board member with the Integrated Healthcare Association (IHA), contributed to that story, and has these further thoughts

Some practices that frequently report E/M services with modifer 25 (Significant, separately identifiable E/M service) are on track to face a dramatic pay reduction.
You’ll find new opportunities to code for services related to care management and behavioral health in 2017, according to the final 2017 Medicare physician fee schedule released Nov. 2. CMS finalized a suite of HCPCS codes for physician-led behavioral health services, two complex chronic care management (CCM) codes, initiating visit codes and more.

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