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    MIPS Measures

    Good Morning - For the previous years we have been doing traditional MIPS measures via claims for one of our general surgeons as he is the only provider in his practice and within this practice goes to 5 hospitals. Since CMS has retired many of the measures that we had previously reported on...
  2. M

    Question MIPS Quality Measure #364--Incidental pulmonary nodule

    Can someone "dumb" down the criteria for reporting MIPS measure #364? I believe I understand, but would love confirmation: Report G9754 if report has incidental pulmonary nodule on a patient 35 and older, does not have cancer or history of, not a heavy smoker or a lung cancer screening...
  3. N

    Anthem OV Denials

    Hello, we have been having a ton of anthem claims being denied because of 99213 being bundled with Medicare (MIPS) codes. IE, G8427, G9903, G8417. The claims are sent electronic and the values for all of them are 0.00. We have tried getting and answer but no one at Anthem seems to understand...
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    Reporting during COVID-19

    Hi, I do not know much at all about MIPS. With that being said, I have been requested to help our clinic review and add measures. It looks like a lot if the measures we are using for our clinic now, are not supported if it was a telehealth visit. What is every one else doing about this or...
  5. 5

    MIPS and who to report this information

    HI, I have been asked to help my administrator with MIPS. Right now, we have been reporting the information to only CMS/Medicare. When I was looking at the guidelines for 2019, it looked like it was not payor driven, that we should also report the codes to Aetna, the blues, work comp, all...
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    Wiki CMS MIPS/MACRA Approved Registry

    Hello everyone, If anyone is looking for a great CMS Registry and or Medical Billing and Coding company, check out www.hpa-billing.com. They are registered on the cms.gov site and provides really great service. They have good references as well. Their fees are not as high as other companies...
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    Quality ID #134 (NQF 0418): Preventive Care and Screening: Screening for Depression a

    I want to be sure that I am interpreting this measure correctly. For Denominator Exclusion the definition: 'Not Eligible for Depression Screening or Follow-Up Plan (Denominator Exclusion) – • Patient has an active diagnosis of depression prior to any encounter during the measurement period-...
  8. Z

    NQF0059 - HBA1C MIPS quality reporting for FQHC

    Our office visit codes are billed out to Part A because of the FQHC status. The only code that is going to go on the Part B claim is the actual lab procedure. Can the CPT II code go on that claim or does there have to be an office visit code on it as well? Can I bill just the lab code with the...
  9. B

    Impact of MACRA on the healthcare industry

    What is the healthcare industry saying about MACRA implementation?