Part B News
ACP numbers surge, yet add-on code remains problematic for many
03/22/2021
by: Roy Edroso
Practices accelerated their use of advance care planning codes 99497 and 99498 in 2019, as more providers held – and billed for – important late-life planning sessions with patients.
As new rule looms, get ready to meet patient PHI email requests and avoid breaches
03/15/2021
by: Roy Edroso
Despite other HIPAA flexibilities implemented for the COVID-19 crisis, you’re still required to protect patient data when you email it to patients and their assigns — and your responsibility will be more closely monitored when a new Office of the National Coordinator for Health IT (ONC) rule goes into effect in April. Make sure you understand what protections you must observe.
It’s official: You can expect more E/M changes to arrive in 2023
03/15/2021
by: Julia Kyles
You have two years to prepare for the next wave of E/M changes. Dozens of changes will go into effect Jan. 1, 2023, according to the CPT Editorial Summary of Panel Actions February 2021, released March 5.
From HIPAA to referral laws, stay connected with the compliance rules for telehealth
03/15/2021
by: Julia Kyles
Practices must be careful about the compliance rules for coding and billing telehealth services, or they will be vulnerable to investigations and fines that could eradicate revenue.
FDA issues emergency authorization for new COVID-19 antibody treatment
03/15/2021
by: Sarah Gould
The Food and Drug Administration (FDA) recently issued an emergency use authorization (EUA) for the combination treatment of bamlanivimab and etesevimab for COVID-19 patients at high risk for severe infection.
Take cues from the note: How to navigate ‘acute’ and ‘chronic’ conditions
03/15/2021
by: Laura Evans
Question: We are struggling to get our providers to document whether the problems they are treating are acute, chronic or acute on chronic. I have not found a guide or publication that instructs coders what to do if this important information is missing except to query the provider. This is causing a lot of upset within our office and I’m wondering if this is one of those issues for which we should create our own internal policy for documentation?
New RUC chair signals the AMA’s commitment to digital health
03/15/2021
by: Julia Kyles
The incoming leader of the influential AMA/Specialty Society Relative Value Scale Update Committee (RUC) appears to be another sign of the AMA’s focus on digital health care.
More Levels 4 and 5 office visits fuel payment gains, despite fewer E/Ms overall
03/15/2021
by: Richard Scott
While the total number of established E/M office visit claims (99211-99215) decreased in recent years, providers still netted a payment increase because of a continued use of Levels 4 and 5 codes.
As watchdog focuses on AWVs and IPPEs, make sure to check timing, use clinical tools
03/08/2021
by: Roy Edroso
Beware of new scrutiny for your annual wellness visits (AWV) and the Welcome to Medicare service — one such code that usually carries a modest denial rate has shown an alarming percentage of improper payments. Make extra sure you’ve fulfilled the basics when you bill them.
Stark law updates deliver eased opportunities for value-based collaboration
03/08/2021
by: Marla Durben Hirsch
CMS’ new rule updating the Stark physician self-referral law brings some welcome relief for physicians who want to participate in value-based initiatives but were afraid of violating the law’s strict referral ban.
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