Clinical Resources Articles
Updates about coding and reimbursement, new practice guidelines, and telemedicine
CMS has proposed revisions to the Physician Fee Schedule for 2019, to reduce the burden of paperwork and allow clinicians to spend more time providing patient care. A listening session has been scheduled, to explain three key provisions from the PFS proposed rule: Streamlining [...]
On Wednesday, July 25, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule outlining changes to the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for potential implementation in 2019. The proposed changes to the two [...]
The Centers for Medicare and Medicaid Services (CMS) is hosting Merit-based Incentive Payment System (MIPS) webinars for the Cost, Improvement Activities, and Quality Performance categories for 2018 to share information on requirements, scoring criteria, and data submission. Information and registration details are provided below. [...]
CMS will host 2017 Performance Feedback and Targeted Review Office Hours to provide a brief overview of Merit-based Incentive Payment System (MIPS) 2017 performance feedback and targeted review, answer frequently asked questions, and highlight helpful resources. All 2017 participants can review MIPS scores and [...]
On July 12 the Centers for Medicare & Medicaid Services (CMS) released the proposed rule that addresses changes to the 2019 Medicare Physician Fee Schedule (PFS) as well as proposed policies for Year 3 of the Quality Payment Program (QPP). A CMS fact sheet [...]
The Centers for Medicare & Medicaid Services (CMS) recently updated the Quality Payment Program website to include several new features. Quality Payment Program Look-Up Tool The Quality Payment Program Look-Up Tool, previously known as the Quality Payment Program Participation Status Tool, now includes both [...]
Question: How do I code for the download and interpretation of smart card/cloud-based data related to PAP usage? Answer: There is no CPT® code that exactly describes the download and interpretation of smart card/cloud-based PAP data. The service is best described by code 99091, [...]
Performance feedback and Merit-based Incentive Payment System (MIPS) scores are now available from the Centers for Medicare and Medicaid Services (CMS) for all individual clinicians and groups that submitted data through the Quality Payment Program (QPP) website for 2017. Advanced Alternative Payment Model (APM) [...]
The Office of Inspector General (OIG) in the U.S. Department of Health and Human Services (HHS) recently conducted a review of a sample of Medicare claims, finding that most Medicare claims for replacement positive airway pressure (PAP) device supplies did not comply with Medicare [...]
Question: If hypopneas are being scored according to Rule D.1.A., is a ≥3% oxygen desaturation required in addition to an associated arousal? Answer: Rule D.1.A. in The AASM Manual for the Scoring of Sleep and Associated Events, Version 2.5, states the following: Score a respiratory event [...]