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Study suggests NPs in the ED cause care concerns. Not everyone agrees.

01/30/2023

A paper questioning the quality and efficacy of care by nurse practitioners (NP) in emergency departments is generating a good deal of press, as well as pushback from advocates for the growing role of non-physician providers in the U.S.

Take note of 4 major deletions in the 2023 NCCI manual

01/30/2023

by: Julia Kyles, CPC

Medicare makes it easy to spot additions to the annual National Correct Coding Initiative (NCCI) manual — new language is printed in red font. However, Medicare doesn’t flag information that has been deleted, revised or moved and Part B News found several notable deletions when it compared each chapter of the 2022 NCCI manual to the 2023 NCCI manual.

Sued for ransomware attack? Hacked health system hit with class action claim

01/30/2023

by: Roy Edroso

A patient has brought a class action suit against a health system, claiming its negligence led to the breach of privacy and potential harm for which the plaintiff seeks damages — an ominous sign for practices in a time of rising ransomware attacks.

Birmingham billing company pays more than $150,000 to settle fraud allegations

01/30/2023

by: Julia Kyles, CPC

Providers are responsible for the claims they submit, but a $153,300 settlement paid by a billing company is a reminder that a practice management company risks disruptive investigations, bad publicity and costly settlements if it is accused of submitting fraudulent claims for a provider.

Lots of losers, though few standouts, in 2023 winners-and-losers code tally

01/30/2023

by: Roy Edroso

The Part B professional fee payment for the delayed creation of an exit site for an embedded catheter (49436) has increased 185.8% in 2023, making it the biggest gainer among the codes covered by the Medicare physician fee schedule that went into effect January 1.

Thwart new ransomware threats, and ‘triple extortion,’ with leveled-up security

01/23/2023

by: Roy Edroso

Ransomware attacks on health care organizations, including physician practices, show no sign of slowing down, and lately they have grown more sophisticated and dangerous. Pay attention to specific warnings from experts in the field.

Changes to ICD-10-CM code set, guidelines cover abuse, neglect, SDOH

01/23/2023

by: DecisionHealth Staff

Come April 1, coders will have additional code options to further capture social determinants of health (SDOH) and abuse and neglect, as CDC released upcoming changes to both the code set and official guidelines on Jan. 9.

Use social determinants of health to reduce burnout, increase patient care

01/23/2023

by: Julia Kyles, CPC

The new batch of diagnosis codes and revised guidelines for social determinants of health (SDOH) that will go into effect April 1 highlight the importance policymakers place on capturing this data. For physicians and qualified health care professionals that are skeptical, let them know that collecting the information can improve patient encounters — and it might not be as much work as they think.

Nurse practitioners reap massive pay gains after E/M fee surge

01/23/2023

by: Richard Scott

Following the pandemic-induced sag in patient encounters in 2020, nurse practitioners nearly returned to pre-COVID levels in 2021 — and with federal dollars buoying E/M services, their payments roared to new heights.

Tap, tap: See better patient results, and provider scores, with SMS outreach

01/16/2023

by: Roy Edroso

A recent study shows automated text messaging to transitional care management (TCM) patients was tied to reduced readmission to the hospital and ED, suggesting that these SMS interventions can go beyond patient-provider convenience and actually improve patient care. They may also boost provider performance ratings — in payer programs and at review websites.

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