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CODING

Here’s how to represent telehealth encounters in QRDA I Format for eCQMs

The Centers for Medicare & Medicaid Services (CMS) has posted additional guidance for using the Quality Reporting Document Architecture I (QRDA I) format to represent telehealth encounters for the Eligible Professional and Eligible Clinician electronic clinical quality measures (eCQMs) used in CMS quality reporting programs for the 2020 and 2021 performance periods. There is no change to the original guidance provided by CMS in July 2020. Representing Telehealth Encounters in QRDA I format by using the Qualifier attribute: To represent “telehealth-eligible” Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes for eCQMs in QRDA I, submitters should use the optional qualifier attribute of the encounter code element to send the telehealth modifier code in addition to the primary “telehealth-eligible” CPT or HCPCS encounter code from the eCQM-specified value sets. The qualifier attribute name is… . . . read more.

CODING ALERT

Physicians should consider these overlooked codes

By Lisa Eramo bio It’s a common complaint heard among primary care physicians: Evaluation and management (E/M) codes don’t adequately capture the time, skill, and resources necessary to plan and coordinate care for patients with complex medical needs. Although new, streamlined E/M guidelines for 2021 may help, several existing remedies can enable physicians to capture additional revenue for the services they provide. More specifically, the U.S. Government Accountability Office (GAO) has published a list of 58 CPT codes that fall under the category of “longitudinal comprehensive care planning” (LCCP) for Medicare beneficiaries diagnosed with a serious or life-threatening illness. These codes include elements of shared decision-making through interdisciplinary care as well as development of a care plan to address the following: Progression of the disease and treatment options Beneficiary’s goals,… . . . read more.

CORONAVIRUS

AMA puts out telemedicine guide

The American Medical Association (AMA) has compiled a guide to help physicians get telemedicine up and running so they can safely care for patients. The telemedicine quick guide outlines the first steps to get started and lays out key considerations to implementing telemedicine and explains policy, coding and payment. Even if your practice didn’t use telemedicine before, it may be an option now. Federal government agencies temporarily relaxed certain federal privacy regulations during the COVID-19 crisis and expanded payment policies. For example, the Centers for Medicare & Medicaid Services (CMS) is letting physicians provide beneficiaries a wider range of health care services without having to visit a health care facility. This CMS fact sheet explains more. Also, the Health and Human Services (HHS) Inspector General is waiving Medicare’s cost-sharing requirements for COVID-19 treatment delivered via telehealth from a doctor’s office or hospital emergency department. Learn more with… . . . read more.

TELEHEALTH

Public health emergency jumpstarts remote care

From video chats to relaxation of state licensing requirements, the coronavirus pandemic has accelerated the adoption of remote and virtual healthcare services. Here is an update from CMS: Medicare Telehealth Visits: Effective for services starting March 6, 2020, and for the duration of the COVID-19 Public Health Emergency (PHE), Medicare will make payments for Medicare telehealth services furnished to patients in broadened circumstances. During the PHE, clinicians can use popular applications that allow for video chat such as Apple FaceTime and Skype, thanks in part to enforcement discretion by the HHS Office of Civil Rights. Clinicians who seek additional privacy protections for telehealth while using video communication products should provide such services through technology vendors that offer HIPAA business associate agreements (BAAs) with their video communication products. In addition, clinicians… . . . read more.

COMPLIANCE

5 tested ways to make your billing and coding more profitable

The health of your medical practice depends on good quality coding and billing work. One of the most important roles in the medical office that…


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INCREASING PROFITS

21 easy ways to boost practice profitability fast

Simple changes to billing procedures, hiring policies, purchasing, patient relations, and other daily activities can have a positive impact on…


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BLOG

What you need to consider before getting started in telemedicine

By Nick Hernandez  bio
Many practices are hearing about telemedicine and becoming increasingly interested in how such a program could…


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YOUR CAREER

Do you have the ‘right stuff’ to be a successful medical office manager?

As the office manager of a medical practice, you have an opportunity to learn, grow, and make a…


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READER TIPS

Use weekly meetings with doctors to keep office running smoothly

Meeting every week with the doctors makes a tremendous difference in how smoothly – and also how successfully – an office operates, says…


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BILLING & COLLECTIONS

This 2 step program makes it easy to collect more money at the time of service

Ask any office “how well do you collect at the time of service?” and the answer will be “outstanding!”…


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