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CMS issues new designated health service list, will stick to annual updates

12/06/2021

Stay on the right side of the Stark physician self-referral rule by studying the new list of designated health services (DHS) before they go into effect Jan. 1, 2022. Revisions to the list were published in the final 2022 Medicare physician fee schedule, although you can expect a new publishing regimen going forward.

Check this list twice: CMS adds 64 codes to the DHS list

12/06/2021

by: Julia Kyles

CMS added 64 codes to the list of designated health services (DHS) that will go into effect next year (see story, p. 4). CMS also removed six codes from the list. The following chart summarizes the changes.

Keep tabs on 8 Open Payments changes, clarifications coming soon

12/06/2021

by: Yvette DeVay, MHA, CPC, CPMA, CIC

While enforcement actions have been scarce, it remains vital to keep track of your status under the Open Payment program, the national transparency model that spotlights the financial relationship between physicians, teaching hospitals and drug/device manufacturers.

Health care workers exempt from vaccine mandate, for now: Judges

12/06/2021

by: Roy Edroso

U.S. health care workers will not have to abide by a federal rule requiring they be vaccinated against COVID-19, pending further court action.

CCM fees on the upswing, while other services get slashed

12/06/2021

by: Richard Scott

You’ll find lucrative pay gains among a series of chronic care management (CCM) services in CY2022, as CMS seeks to expand their use. Yet not all fee changes are as propitious. Dozens of codes are taking fee hits, including a series of gastrointestinal services.

Pushback prompts CMS to alter course on critical care policy

11/22/2021

by: Julia Kyles, CPC

A revised policy that will go into effect Jan. 1, 2022, represents two wins for the medical practices, individual practitioners and various organizations that protested unpopular sections of CMS’ proposed policies for critical care services (99291-99292).

Split/shared for critical care: Focus on timekeeping, activity tracking, modifiers

11/22/2021

by: Julia Kyles, CPC

CMS will allow split/shared billing for critical care services effective Jan. 1, 2022, but you should complete training on the guidelines before submitting a claim for encounters that involve both a physician and non-physician practitioner (NPP).

Vaccine mandate skirts physician practices but may cover some employees

11/22/2021

by: Roy Edroso

The CMS interim final rule requiring health care facilities to vaccinate their staff does not directly cite physician practices, but that doesn’t mean you’re completely free. Watch out for circumstances that might require at least some of your staff to get vaccinated anyway.

Need cyber insurance? Beef up security as coverage gets more costly, demanding

11/22/2021

by: Roy Edroso

Thanks to a wave of ransomware attacks, the cyber insurance market is expanding. Yet the rise of cybercrime also means that premiums are rising and limits are tightening. Be aware of what insurers are doing, and how you can get the most out of the policy you pick.

CMS expands scope of OIG exclusions list; hints at short-period claims reviews

11/22/2021

by: Richard Scott

CMS confirmed that it is finalizing an earlier proposal to expand the list of personnel who may fall into the Office of Inspector General’s (OIG) exclusions list for provider and supplier enrollment.

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