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Patient-centered medical homes generate results but can increase costs

06/09/2017

Physician practices that transition to patient-centered medical homes (PCMH) are reaping benefits that include extra reimbursements and credit under the Merit-Based Incentive Payment System (MIPS). But practices also must invest a considerable amount of time and effort into becoming a PCMH, an investment that can strain the finances of small practices.

Use a 6-step plan to correctly calibrate cognitive-assessment reporting

06/05/2017

by: Richard Scott

Don’t get snarled in the heavy traffic that surrounds dementia-care code G0505. Instead, gather the necessary assessment tools, deploy your staff appropriately and harness other tips to line up a success strategy in advance.

G0505 Audit Form

06/05/2017

by: Richard Scott

Use this audit tool to keep track of the service elements you need to report for cognitive-care code G0505.

G0505 Katz Index

06/05/2017

by: Richard Scott

Fulfill the functional-assessment requirement for cognitive-care code G0505 with the Katz Index of Independence in Activities of Daily Living.

G0505 Mini-Cog

06/05/2017

by: Richard Scott

Put this tool to use to accurately stage dementia and assess your patient's cognitive health.

G0505 PHQ-2

06/05/2017

by: Richard Scott

Use this two-point questionnaire to understand your patients' feelings of depression, a key part of the service requirements for G0505.

Dutifully document improvement activities during inaugural year of MIPS or risk payments

06/05/2017

by: Richard Scott

Take a close look at the documentation guidelines that CMS suggests for the practice improvement portion of the merit-based incentive payment system (MIPS) and you may ward off future audits and avoid having to forfeit revenue.

Malpractice insurance rates may drop under Trump budget; CBO deals AHCA a blow

06/05/2017

by: Roy Edroso

Take note of the latest health policy updates impacting physician practices from Washington, D.C.

Modifier 78 good for a return trip to the OR — but not the doctor’s office

06/05/2017

by: Roy Edroso

Question: Our patient had a mastectomy and developed a seroma in the post-operative period. We performed drainage of the seroma in the doctor’s office. Can we bill with modifier 78 (Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period)?

Modifier 78: Little used, and much denied — for some codes in particular

06/05/2017

by: Roy Edroso

Modifier 78 (Unplanned return to the operating/procedure room by the same physician) is a tough one to get accepted by Medicare contractors. In fact, an analysis of the most recent Medicare data available shows the aggregate denial rate for codes with 78 was 27%. But some codes do much better with it than others.

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