In Billing
Dec 28th, 2017
In August 2017, UnitedHealthcare (UHC) indicated they would no longer reimburse inpatient and outpatient consultation codes, as of Oct. 1, 2017. When the implementation date came, UHC indicated they would delay the consultation services revision until 2018: We previously announced that certain revisions to the Consultation Services Reimbursement Policy would become effective for UnitedHealthcare Co...
As payers like Aetna, ANthem, Cigna, Humana, UHC, SelectHealth, Blue Cross/Blue Shield embrace telehealth and establish their own programs, major healthcare networks are also reaping benefits from the exploding technology. Large networks like Kaiser Pemanente, Geisinger, Cleveland Clinic, and UPMC Health Plan are incorporating telehealth not only for outpatients but for inpatients. In an article ...
The medical decision-making (MDM) component of evaluation and management (E/M) services is perhaps the most crucial element in determining the correct level of service assignment for patient encounters. The majority of individuals involved in the E/M coding process may not agree on the interpretation of the components, but would agree that the clinical thought process ...
The U.S. Preventive Services Task Force (USPSTF) has released a new recommendation for obesity screening in children and adolescents. The USPSTF recommends that clinicians screen for obesity in children and adolescents 6 years and older, and offer or refer overweight individuals to comprehensive, intensive behavioral interventions to promote improvements in weight status. This recommendation is bas...
In CMS
Jul 14th, 2017
Among the many provisions detailed within the 2018 Physician Fee Schedule Proposed Rule, released July 13, the Centers for Medicare & Medicaid Services (CMS) acknowledges that the current evaluation and management documentation guidelines create an administrative burden and increased audit risk for providers: Stakeholders have long maintained that both the 1995 and 1997 guidelines are ...