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CCI version 24.3 scorecard: 942 new code pairs, 148 MUE revisions

09/17/2018

The latest Correct Coding Initiative (CCI) edits, which take effect Oct. 1, contain 942 new code pairs that bundle a range of services across the CPT and HCPCS code sets. The CCI update also feature 45 newly placed caps on services under the medically unlikely edits (MUEs) section. Nearly 150 MUEs have been revised. Check out the CCI version 24.3 scorecard to find out which code families are affected.

Non-compete clauses may not bind; give the judge some leeway or lose all

09/17/2018

by: Roy Edroso

Q: We have non-compete clauses in our doctors’ contracts, saying when they leave us they can’t practice within a certain radius of our offices for a certain period of time. But lately I’ve been noticing legal cases in the paper where doctors have challenged their non-competes and judges have released them. What were those practices doing wrong and how can we avoid it?

4 tips to ease task of querying clinicians on coding matters

09/17/2018

by: Laura Evans

When you must approach your physician with a coding question, keep these four points in mind to ensure an efficient response with a minimum of fuss, advises a nationally known expert in clinical documentation improvement (CDI)/

MGMA comes out strong for delay in E/M changes, making AUC voluntary

09/17/2018

by: Roy Edroso

The 40,000-member Medical Group Management Association (MGMA) is asking CMS to rethink its reconfiguration of E/M coding and documentation for Medicare, adding to the growing pressure on the agency to pull back on the controversial proposal, as well as for other changes in the proposed 2019 Medicare physician fee schedule/Quality Payment Program (QPP) rule.

Prolonged codes for clinical staff go largely unused, face high denials

09/17/2018

by: Richard Scott

Most practices have been hesitant to tap into the prolonged service codes that are allowed when clinical staff spend extra time with a patient. Even as service utilization increased about 97% between 2016 and 2017, total claims remain scarce.

CPT 2019: Check the 6 new E/M codes, and don't overlook the new guidelines

09/10/2018

by: DecisionHealth Editorial Staff

You’ll find new guidance that will help practices document services, code correctly and combat denials in your 2019 CPT manual. The electronic version of the 2019 CPT manual is available and DecisionHealth has reviewed the book to create this overview of some of the revisions and additions in next year's manual.

E/M pay proposals elicit scorn, concern from much of the medical community

09/10/2018

by: Richard Scott

As soon as Jan. 1, the entire sub-structure supporting outpatient E/M encounters could get razed, as Medicare seeks to transform the current methods of documentation and payment for a batch of services that practices report millions of times per year. While the provider community is welcoming of documentation changes, payment revisions remain a tremendous sticking point.

As ransomware heats up, here are 6 preventive steps that can save your data

09/10/2018

by: Roy Edroso

You could be doing your “due diligence” on cybersecurity and still get hit by a ransomware attack. These six extra steps can beef up your defenses.

Find the right partners to make virtual groups for MIPS worth it for your practice

09/10/2018

by: Roy Edroso

You have until the end of the year to sign up for Merit-based Incentive Payment System (MIPS) virtual groups, and teaming up with complementary providers may help you get better scores more easily.

Proposed 50% markdown on E/M+25 scenarios means losses for common combos

09/10/2018

by: Roy Edroso

CMS’ plan in the proposed 2019 Medicare physician fee schedule to cut either a E/M charge or a procedure charge when modifier 25 is used would, if finalized, require some billing changes – and result in varying degrees of loss -- in common scenarios.

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