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QPP in the PFS 2019: More patient, outcome focus; ‘gold’ quality measures; other changes

07/23/2018

CMS shows it means business about outcome and patient-reported measures in the Quality Payment Program (QPP) and the merit-based incentive payment system (MIPS) section of the proposed 2019 Medicare physician fee schedule with measure changes that increase the focus in those areas. Other meaningful changes include a stripped-down, information-exchange-focused Promoting Interoperability category; new standards for small practices and low-volume exemptions; a proposed “tiered” quality scoring system; and more.

CMS proposes multi-service reduction for office procedures, E/Ms

07/23/2018

by: Laura Evans

Clinicians could see a cut to their Medicare reimbursement next year when an E/M visit is reported the same day as an office procedure.

Proposed rule provides an early look at next year’s coding changes

07/23/2018

by: Julia Kyles

You can expect 81 new codes, 27 deleted codes and more than a dozen revised CPT codes and HCPCS codes in 2019, according to the proposed 2019 Medicare physician fee schedule. In addition, CMS intends to shift the status of four E/M codes from bundled to active.

Proposed fee schedule round-up: Payment, policy, coding changes

07/23/2018

by: PBN Staff

Part B News staff combed the 1,473 pages of the proposed 2019 Medicare physician fee schedule to bring you complete coverage of the changes that could affect your practice.

Single-rate E/M pay structure creates winners, losers under proposed fee schedule

07/23/2018

by: Richard Scott

Some specialties, including podiatry and dermatology, would see a significant pay increase for E/M services should CMS’ proposal to group level 2 through 5 outpatient codes into one payment basket go into effect on Jan. 1, according to a reimbursement estimates contained in the proposed 2019 Medicare physician fee schedule released July 12.

Wellness programs help but workflow fixes chill physician burnout

07/16/2018

by: Roy Edroso

Physician burnout is a hot issue with a mountain of studies devoted to it. Health care organizations have begun to institute programs to relieve it, but some experts think you can make a big difference by simply making providers’ workflow more efficient, leaving them freer to practice medicine.

Revised remittance advice codes alert providers to QMB balance billing scenarios

07/16/2018

by: Richard Scott

Pay close attention to revised remittance advice remark codes (RARCs) pertaining to unsupported qualified Medicare beneficiary (QMB) billing or you could wind up getting sanctioned by the federal government.

‘Siri, violate HIPAA.’ Beware 7 real risks of virtual voice assistants.

07/16/2018

by: Marla Durben Hirsch

Voice-activated virtual assistants, such as Amazon’s Echo and Google Home, are convenient and helpful. They’re rising in popularity with doctors, but they can create legal headaches when used in a physician practice.

Use JW modifier for skin substitute biologics from a single package

07/16/2018

by: Richard Scott

Medical practices have recently been required to submit the modifier JW (Drug amount discarded/not administered to any patient) to denote the unused portion of certain drugs and biologics that come in single-use packages. You should now add skin substitute products to the list, as well.

Tie up your diabetic shoe reporting with correct ICD-10 codes, certifying statements

07/16/2018

by: Richard Scott

Size up your patients who have diabetes to see if they require special footwear or orthotics and ensure your documentation shows a required history of illness — and an appropriate diagnosis code — to get their care started on the right foot.

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