The proposal is on the table as part of proposed E&M changes. EDITOR’S NOTE: The following story was published by RACmonitor on Aug. 16, 2018. By now I am sure that everyone is well aware that the Centers for Medicare & Medicaid Services (CMS) has proposed modifications to the reimbursement…
Proposed E&M code changes would impact specialty physicians. Some physicians are probably not very happy with recently proposed changes to the Medicare Physician Fee Schedule. The Centers for Medicare & Medicaid Services (CMS) designed the changes to reduce paperwork and enable physicians to spend more time with patients. Those seem…
HATA survey reveals membership dissatisfaction with prior authorization transactions. In a recent report to the U.S. Senate Committee on Finance, the Government Accountability Office (GAO) was asked to examine the Centers for Medicare & Medicaid Services’ (CMS’s) prior authorization programs, including its benefits and challenges. The GAO spoke with many…
The OIG continues to review cases of malnutrition. The diagnosis of severe protein calorie malnutrition is under high scrutiny from the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). Today, I’d like to explore the reasons…
Proposed rule on 2019 Physician Fee Schedule offers greater incentives Revisions in the Quality Payment Program (QPP) proposed rule, tucked into the 2019 Physician Fee Schedule, will make for heightened competition and expectations among physicians participating in the Merit-based Incentive Payment System (MIPS) as the Centers for Medicare & Medicaid…
Overview of CMS final rules is provided by the author So this is the season for 2019 Medicare facility payment rules. These rules are required each year to update payment rates and processes, as well as additional policies for the next fiscal year, which begins on Oct. 1. These are…
The author comments on proposed E&M changes. Has my entire career been based on a lie? For 33 years, I have been espousing the party line that good documentation positively impacts patient care. I have taught documentation to providers who have gotten in trouble with their medical boards for six…
CMS proposes significant changes to E&M services. There has been much confusion over the years regarding documenting for evaluation and management (E&M) services since the 1997 Official Guidelines were released. The Centers for Medicare & Medicaid Services (CMS) kept promising revised guidelines for years without delivering results.  During that time,…
Major E&M changes on the horizon. Probably the biggest change in healthcare in two decades is the Centers for Medicare & Medicaid Services (CMS) proposal to redefine the documentation requirements for evaluation and management (E&M) coding in 2019. The agency is proposing to forego the 1995 and 1997 guidelines for…
CMS proposed major changes to E&M coding but still solicits feedback from stakeholders. The Centers for Medicare & Medicaid Services (CMS) wants to simplify outpatient E&M coding by letting providers choose an office visit code level based on the most important component, medical decision making (MDM), or face time spent…