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Practices that aren’t comfortable with the guidelines for office and other outpatient E/M visits may downcode their claims because they mistakenly believe it will protect them from audits. In addition, some private payers may automatically downcode high level claims.
Practices will be breaking in a new set of E/M guidelines for their visits in a facility starting in January of 2023, according to an AMA official. But you can expect to see the coding and guideline changes sooner than that: CMS wants to have a first look at them by early summer of this year.
First impressions can be deceiving. The descriptor for modifier FT is a prime example.
The official count is in. While the plight of physician practices during the COVID pandmic is well-known, new data from CMS provides a full accounting of the grisly financial landscape.
If you’ve been following the split (or shared) and critical care saga you know that Medicare announced in the final 2022 Medicare physician fee schedule that it would require new modifiers with the services.


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