Monday, September 10, 2018

Advance Care Planning

CMS started paying for voluntary Advance Care Planning (ACP) from January 1, 2016.

ACP helps Medicare patients decide the plan of care that they would like to get when they are unable to take such decisions themselves.

Voluntary ACP is a face-to-face service between a physician (or other qualified health care  professional) and a patient discussing advance directives with or without completing relevant legal forms. An advance directive is a document in which a patient appoints an agent and/or records the  wishes of a patient pertaining to their medical treatment at a future time if they cannot decide for themselves at that time.

There are no limits on the number of times you can report ACP for a given patient in a given time period. When billing the service multiple times for a given patient, document the change in the patient's health status and/or wishes regarding their end-of-life care.

There are no place-of-service limitations on ACP services. You can appropriately furnish ACP services in facility and non-facility settings. ACP services are not limited to a 
particular physician specialty.

CMS requires no specific diagnosis to bill the ACP codes.

CPT 99497                
Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first  30 minutes, face-to-face with the patient, family member(s), and/or surrogate

CPT 99498      
Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (List separately in addition to code for primary procedure)

Retrieved from https://www.medicare.gov/coverage/advance-care-planning.html

For more information refer the following link :  https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/AdvanceCarePlanning.pdf

Wednesday, May 30, 2018

Are you Eligible for MIPS in 2018 ?

You are eligible and are required to submit data for MIPS 2018, if you are a,
  • Physician (including doctors of medicine, doctors of osteopathy, osteopathic practitioners, doctors of dental surgery, doctors of dental medicine, doctors of podiatric medicine, doctors of optometry, and chiropractors)
  • Physician Assistant
  • Nurse Practitioner
  • Clinical Nurse Specialist
  • Certified Registered Nurse Anesthetist
OR

if you see more than 200 Medicare patients annually

OR

if you bill Medicare more than $90,000 in Allowed charges annually.


You are exempt
from MIPS 2018, if you,

  • do not meet any of the criteria above
  • enroll in Medicare for the first time in 2018
  • participate in an advanced APM wherein you receive 25% of the Medicare payments or see 20% of the Medicare patients from an advanced APM

You can also know your MIPS 2018 eligibility by clicking this link  https://qpp.cms.gov/participation-lookup  and entering your 10-digit National Provider Identifier (NPI) number to view your MIPS participation status.

Friday, January 12, 2018

Abdomen X-ray coding in 2018

Abdomen X-ray codes have changed, the old Abdomen X-ray codes 74000, 74020 are being deleted and are being replaced by 74018, 74019 and 74021.

As the new Abdomen X-ray codes are coded based on the number of views, from a documentation compliance standpoint it is imperative for the practice to ensure that the number of views are appropriately documented.

The new Abdomen X-ray codes are,
  • 74018 Radiologic examination, abdomen; single view
  • 74019 Radiologic examination, abdomen; two views
  • 74021 Radiologic examination, abdomen; three or more views

Thursday, January 11, 2018

Chest X-ray coding in 2018

Chest X-ray coding has become simpler in 2018, the chest x-ray codes are some of the most frequently used imaging codes in healthcare.

Previously Chest X-ray codes used nine different codes, now these nine codes have been replaced with four codes that are simply determined by the number of views.

As  the new Chest X-ray codes are coded based on the number of views, from a documentation compliance standpoint it is imperative for the practice to ensure that the different types / number of views are appropriately documented.

The new Chest X-ray codes are,

  • 71045 Radiologic examination, chest; single view
  • 71046 Radiologic examination, chest; 2 views
  • 71047 Radiologic examination, chest; 3 views
  • 71048 Radiologic examination, chest; 4 or more views