In 2019, there are some changes to the Promoting Interoperability performance category of MIPS. Here’s what you need to know about CEHRT and scoring news for this performance year. Background: MACRA requires the Quality Payment Program (QPP) to include a MIPS performance category on meaningful use of certified EHR technology, the QPP 2019 rule states. […]
Continue reading...24. January 2019
The 2018 CERT report estimates 58 percent of Medicare improper payments were caused by insufficient documentation (and this is an ongoing trend). More than half is nothing to sneeze at, especially when you consider that those documentation problems could lead to having to repay Medicare or having to spend time working on underpayments. Here’s a […]
Continue reading...17. January 2019
If a picture is worth 1,000 words, how much is evaluating a picture worth? Medicare has taken a stance on that. As of Jan. 1, 2019, Medicare is paying for remote evaluation of pre-recorded patient videos and images reported using G2010. Here’s what we know from the Medicare Physician Fee Schedule Final Rule. Compare Our […]
Continue reading...7. January 2019
Exploiting modifier 59 was a major factor in a recent $12.5 million settlement for False Claims Act allegations. How’s that for motivation to shore up your modifier 59 know-how? Here are some resources to get you on your way. Read the Write-Up on the Recent False Claims Act Settlement Find out some of the details […]
Continue reading...20. December 2018
We’ve been talking a lot about the 2019 Medicare Physician Fee Schedule final rule, but when there are changes to E/M rules, there can never be enough information, right? CMS recently released a response to a question that arose during a provider call about what parts of history ancillary staff or the beneficiary can document […]
Continue reading...10. December 2018
Understanding the Medicare Quality Payment Program (QPP) is tough. But the data Medicare released from the 2017 performance year shows you were up for the challenge. And that’s good news because the 2017 performance year affects 2019 Medicare payments and maybe has helped you prepare for the 2019 performance year, too. Let’s see how you […]
Continue reading...4. December 2018
When MACRA and MIPS come up, does it feel like speaking another language? For the 2019 performance year, there are even some new terms to learn. We’ve got the new language and tips on where you’ll see it used so you don’t have to spend time searching. Collection Type: Apply to Sets of Similar Quality […]
Continue reading...5. November 2018
Medicare released the CY 2019 Medicare Physician Fee Schedule (MPFS). One of the big questions from the proposed rule was whether E/M payment rules would change. Here are some highlights on what made it into the final rule for E/M and what didn’t. The News You’ve Been Waiting for … The proposal to combine payment […]
Continue reading...25. October 2018
If you come across documentation that refers to ruling out a diagnosis, it’s time to go on high alert. There are some specific rules you need to follow for ICD-10-CM coding. Here are tips straight from the 2019 ICD-10-CM Official Guidelines for Coding and Reporting (OGs). 1. Know When to Use Codes That Specify ‘Ruled […]
Continue reading...10. October 2018
Let’s put data to work to help prevent denials! CGS is one of the Medicare contractors that provides information on top claim denial reasons, and here we’ll take a look at some denial triggers from August 2018 and how you can prevent them. Check Status Before Reporting Duplicate Service Reporting the exact same service […]
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4. February 2019
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