Part B News
08/20/2018

Question: A patient who steppad and cut herself on a piece of glass months earlier still complained of pain in the area, though the wound was healed. A CT scan showed increased density in the subcutaneous fat on the plantar aspect. Surgery revealed a large, thick, deep callus extending through the dermis down to the subcutaneous tissue and extensive scar tissue. These were excised but no foreign object was found. We’re using 28192 (Removal of foreign body, foot; deep) but is that correct — seeing as we didn’t actually find a foreign body?

08/13/2018
As practices absorb the lingering aftershock of CMS’ proposals targeting E/M services and documentation standards, the impact on a group’s bottom line remains a wide-open question. Yet a detailed analysis from Part B News signals that, should the agency’s core pay proposals come to pass, many providers are set to see a significant pay increase.
08/13/2018
Starting Oct. 1, coding guidelines will no longer allow for a connection to be assumed between Takotsubo syndrome (I51.81) and hypertension.
08/13/2018

A new federal rule is expected to promote short-term, limited-duration (STLD) health plans that aren’t required to cover services mandated by the Affordable Care Act (ACA), and you should make sure your patients who move to those plans know how that affects their bills.

08/13/2018
A new study suggests that the time crunch in patient encounters is keeping patients from getting their concerns addressed — but you can get around that by adding a process to put some of the responsibility on the patient.
08/13/2018
There are 115 CPT codes accepted by Medicare that relate to the removal of a foreign body, and in 2016, the most recent year for which we have Medicare data, they were used only 491,376 times, with 18 codes being used fewer than 100 times, and 62163 (Neuroendoscopy, intracranial; with retrieval of foreign body) used zero times.
08/13/2018
As CMS considers significant E/M pay revisions, your reimbursement may vary based on the exact proposals the agency winds up adopting. The chart below compares the pay-rate differences between the current E/M rates and the single-stream rates for codes 99212-99215. The chart also details the positive impact of the proposed add-on codes that would apply to a dozen specialists.
08/06/2018

A new study suggests that the time crunch in patient encounters is keeping patients from getting their concerns addressed – but you can get around that by adding a process to put some of the responsibility on the patient.

08/06/2018

The Trump administration’s reinstatement of risk-adjustment payments is a genuine benefit for the insurance exchanges created under the Affordable Care Act (ACA), aka Obamacare, whether that was the president’s primary motivation or not. But there are still big challenges waiting in the wings for the exchanges, which currently cover 11.8 million Americans.

08/06/2018

CMS’ 2019 Hospital Outpatient Prospective Payment System (OPPS) proposed rule introduces policies to reduce reimbursement for hospital outpatient clinic visits at off-campus, provider-based departments (PBD) and expand last year’s payment reductions for drugs purchased under the 340B discount pricing program by nonexcepted PBDs.

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