Anthem Fully Rescinds Modifier 25 Cuts

By | 2018, Regulatory Compliance
Anthem Fully Rescinds Modifier 25 Cuts Physician practices and hospitals participating with Anthem Blue Cross Blue Shield (BCBS) will no longer see any payment reduction on E/M services they bill with modifier 25 attached, a top Anthem official confirms in a letter to the AMA. The insurer had been set to implement a 25% payment...
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CMS unveils new, voluntary bundled payments program

By | 2018, Practice Operations, Regulatory Compliance
CMS unveils new, voluntary bundled payments program Shortly after announcing that it has eliminated several existing bundled payment initiatives, CMS has announced a new bundled payment model that focuses on voluntary participation. Dubbed “Bundled Payments for Care Improvement Advanced” (BPCI Advanced), the new program is based on the older BPCI program that it replaces. CMS...
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MedPAC recommends eliminating MIPS

By | 2018, Coding and Auditing, Practice Operations, Regulatory Compliance
MedPAC recommends eliminating MIPS By Grant Huang Director of Content at DoctorsManagement A top Congressional advisory body has voted to recommend that Congress repeal the Merit-based Incentive Payment System (MIPS) and replace it with a simpler version that would not be mandatory like MIPS is for most providers who participate with Medicare. The Medicare Payment...
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Modifier 25 revisited: Bundling E/M visits and procedures

By | 2018, Coding and Auditing, Regulatory Compliance
Modifier 25 revisited: Bundling E/M visits and procedures By: Scott Kraft, CPC, CPMA Auditor and Consultant at DoctorsManagement As more payers embrace hardline policies to discourage the bundling of E/M services with minor outpatient procedures (see related story, pg. 3), practices must be more disciplined in their use of modifier 25 (significant, separately identifiable evaluation...
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