Clinical Resources Articles
Updates about coding and reimbursement, new practice guidelines, and telemedicine
The Centers for Medicare and Medicaid Services (CMS) is hosting a national provider call about Physician Compare on Oct. 30, 2018, from 1:30 – 3 p.m. EDT. Physician Compare shares publicly reported performance information about clinicians and groups, which is pulled from the Provider [...]
The AASM Payer Policy Review Committee recently developed new scorecards for eight payer policies, focusing on diagnostic testing for obstructive sleep apnea (OSA) in adults. The committee evaluated the insurers’ policies and assigned a score based on nine criteria, aligned with the AASM’s Clinical [...]
The Centers for Medicare and Medicaid Services (CMS) has reviewed the adjustment factors and identified several errors in the scoring logic for the Merit-based Incentive Payment System (MIPS), resulting in several corrections to 2017 final scores and 2019 payment adjustments. Additional changes also have [...]
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, [...]