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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.
Check your payer contracts and correspondence for signs that insurance companies are charging you to receive your medical reimbursement payments via electronic funds transfer (EFT).
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.
After weeks of secret meetings, Senate Republicans have released a ‘discussion draft’ of their proposal to repeal and replace the Affordable Care Act and hope to rush the sweeping legislation to a Senate floor vote before the July 4 recess.

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