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Use this crosswalk of 18 new drug codes to replace previous HCPCS codes

03/13/2017

Effective Jan. 1, CMS released 18 new HCPCS codes — all J codes — to replace 12 C codes and two Q codes for drugs.

When reporting CCM initiating visit code G0506, watch level of E/M service

03/13/2017

Question: If a patient is brought into the office for the physician or non-physician practitioner (NPP) to develop the chronic care management (CCM) care plan, am I eligible to bill initiating visit code G0506 as well as an E/M office visit code?

Practices vanquish transitional care management demons, boost earnings

03/13/2017

by: Richard Scott

When it comes to billing transitional care management (TCM) codes 99495 and 99496, it appears practice truly does make perfect — or something close. Following some early hiccups, practices netted more than $103 million in reimbursement for TCM claims in 2015, the latest year of available Medicare claims data.

Contractors for small-practice QPP help

03/13/2017

Here are the contractors chosen to help small practices with QPP.

ACI standards streamlined but still a challenge

03/10/2017

Physician practices are working with a new set of rules when it comes to engaging patients online and encouraging them to view their medical records, and the new Advancing Care Information (ACI) program has made some standards easier to reach than those under the meaningful use program that it replaced.
Under the revised rules for the Merit-based Incentive Payment System (MIPS), many minimum reporting thresholds under ACI are lower than those imposed under modified Stage 2 and Stage 3 meaningful use, and physicians are required to report on fewer measures using a more streamlined scoring system.

Verma advances; Trump touts tax credits; high-risk pools loom

03/06/2017

by: Richard Scott

On March 2, the Senate Finance Committee cast a narrow 13-12 vote to send Seema Verma, the nominee to lead CMS, ahead to a full Senate confirmation. Best known as the architect of Indiana’s Medicaid program, which is largely centered around block grants as a thoroughfare for coverage, Verma would report to new HHS Secretary Tom Price.

Use benchmark data to predict — and boost — your MIPS quality scores

03/06/2017

by: Richard Scott

Don’t overlook benchmark data when you report quality measures under the merit-based incentive payment system (MIPS) this year. While a 98% success rate for documenting patients’ current medications may sound great, it will leave you more likely to incur a penalty.

Concierge medicine gets more popular – and maybe more possible for you

03/06/2017

by: Roy Edroso

You may not have to give up all insurance for your practice to do concierge medicine, which a recent study shows is becoming more attractive to providers.

Watch billing gaps when you adopt new flu vaccine code 90682

03/06/2017

As the flu season drags on, get ready to add a new line item to your seasonal reporting checklist – but watch out for the slow roll-out of the new vaccine code to avoid any billing hiccups.

When patient comes from ER, watch HPI elements, medication management

03/06/2017

by: Roy Edroso

We saw a patient who was recently in the emergency department (ED). The report states chest pain as the reason for visit/chief complaint. Can we use this as the chief complaint and location as an HPI element if the ED doctor does not restate it?

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