CMS 2019 fee schedule takes modifier 25 cuts, runs with them

By | 2018, Coding and Auditing
CMS 2019 fee schedule takes modifier 25 cuts, runs with them Grant Huang, CPC, CPMA Director of Content With so much focus on the potential E&M reimbursement reductions that could result from the CMS proposed rule changes in its 2019 Physician Fee Schedule (PFS), there’s another crucial E&M provision that’s gotten precious little attention – but could significantly...
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Getting the Right Eligibility Information for Payment – Your Rights and Health Plan’s Requirement

By | 2018, Coding and Auditing
Getting the Right Eligibility Information for Payment - Your Rights and Health Plan's Requirement Stanley Nachimson Principal, Nachimson Advisors, LLC This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. We need timely and accurate patient information to bill health plans...
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CMS proposes a leaner MIPS for in 2019

By | 2018, Coding and Auditing, Regulatory Compliance
CMS proposes a leaner MIPS for in 2019 Next year, CMS wants the Merit-based Incentive Payment System (MIPS) to be more streamlined, with fewer measures to report, expanded eligibility for non-physician providers to participate, and various tweaks to the four MIPS performance categories. The provisions appear in the Quality Payment Program (QPP) proposed rule, which...
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How to access your 2017 MIPS feedback report

By | 2018, Coding and Auditing, Regulatory Compliance
How to access your 2017 MIPS feedback report Your providers’ report cards for the 2017 reporting year of Medicare’s Merit-based Incentive Payment System (MIPS) are finally out, released by CMS via their Quality Payment Program website. So long as an eligible provider (MD, DO, nurse practitioners and physician assistants) submitted any MIPS data during 2017,...
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CMS proposal simplifies E/M coding but complicates payments

By | 2018, Coding and Auditing
CMS proposal simplifies E/M coding but complicates payments CMS wants to simplify outpatient E/M coding by letting providers choose an office visit code level based on the most important component, medical decision making (MDM), or face time spent with the patient – without the existing requirement that the visit be counseling-dominated. This bombshell provision, appearing...
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CMS proposal simplifies E/M coding but complicates payments

By | 2018, Coding and Auditing, Regulatory Compliance
CMS proposal simplifies E/M coding but complicates payments Grant Huang, CPC, CPMA Director of Content CMS wants to simplify outpatient E/M coding by letting providers choose an office visit code level based on the most important component, medical decision making (MDM), or face time spent with the patient – without the existing requirement that the...
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