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New ICD-10 e-cigarette abuse, heart attack codes coming for use Oct. 1

03/20/2017

In mid-April, practices will get a first look at many — but not all — of the ICD-10-CM code changes that will take effect Oct. 1. That’s when CMS releases the changes as part of the proposed Medicare inpatient hospital payment rule.

4 areas where telehealth, though under-covered, can bring in revenue

03/20/2017

by: Roy Edroso

For most providers, reimbursement for telehealth is spotty at best, but look to these key programs that will pay you for the remote work while setting you up for future success.

Turn to secondary insurance, talking points to avoid CCM copay barriers

03/20/2017

by: Richard Scott

If cost-sharing for chronic care management (CCM) services has turned patients off — as multiple practices told CMS during a Feb. 21 webinar — then you should stick to a script and explore secondary insurance coverage.

Fine tune your patient messaging to boost CCM rolls

03/20/2017

by: Richard Scott

Stick to direct and open conversations with your patients when discussing chronic care management (CCM) services and you may boost your patient buy-in. The following example, provided courtesy of consultancy West Corporation, gives you a head start with your CCM discussions.

5 steps to make sure insurance coverage, staff are prepared for disaster

03/20/2017

by: Roy Edroso

Question: I read about a doctor’s office that was destroyed in a fire, and it occurred to me that we don’t have a protocol for emergencies. What’s a good checklist?

Despite lack of guidance, X modifiers not denied much more than 59

03/20/2017

by: Roy Edroso

If you haven’t been using X modifiers because you’re afraid it will increase denials, you may be surprised by their actual denial rates.

Concierge medicine model continues to grow

03/17/2017

Concierge medicine is still a niche industry, but in an era of decreasing reimbursements and increasing government regulation, it has become a more attractive option for some physicians running a small practice. The concierge business model, which operates under several names including “direct pay,” has been around for 20 years and once catered to wealthy clients in affluent urban and suburban areas. But changes in the way small practices operate—and the proliferation of high-deductible health plans—is prompting physicians and consumers to give the model a second look.

Prognosis negative for GOP’s ACA replacement legislation; MedPAC on MIPS; and more

03/13/2017

by: Roy Edroso

The Republicans’ Affordable Care Act (ACA) repeal-and-replace bill, the American Health Care Act (AHCA) released Feb. 6, neither repeals nor replaces the law popularly known as Obamacare. The 123-page bill retains to a large extent the original ACA legal framework for regulating insurance plans and their purchases. And here’s another similarity with Obamacare: It has politicians rushing to denounce it.

How to get free QPP help whether you’re a small or large practice

03/13/2017

by: Roy Edroso

If you have 15 or fewer providers – and even if you have more – you can get free help with the quality payment program (QPP) and avoid being one of of the small practices CMS has judged susceptible to QPP penalties.

Injections get bundled, prolonged services limited in CCI update

03/13/2017

by: Richard Scott

You’ll find a cap on how much time you can bill for non-face-to-face prolonged services, numerous injection-code bundles and a revised limit on cerumen-removal coding among other updates in the latest Correct Coding Initiative (CCI) quarterly release.

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