BCBS is Reducing Payment for E/M Service on the Same Day as Procedure

CPT Modifier 25

Recent payer policies will only reimburse 50% when an E/M and procedure are performed on the same day. Payers are now adding a layer of complexity by reducing the Evaluation and Management (E/M) service payment by 50% when a separately identifiable E/M service is provided in addition to the minor procedure performed. The use of […]

Help Improve Prior Authorizations

Prior authorizations are a significant administrative burden and the current process is cumbersome, inefficient, and costly, and ultimately delays radiology and interventional specialist patient care. Act now to help improve prior authorizations. Urge your Representatives and Senators to support the “Improving Seniors” Timely Access to Care Act of 2024″ (S. 4518/H.R. 8702). This bipartisan bill […]

Proper Nurse Visit Billing for Minimal Problems

AMA Definition – Minimal Problem Since 2021, the AMA definition of a “minimal problem” is a problem that may not require the presence of the provider. This type of visit is performed “incident-to” an established care plan and under the direct supervision of the physician or non-physician. Performance or supervision of these services typically takes […]

URGENT – Check Email for AMA Practice Expense Survey

The American Medical Association (AMA) contracted with Mathematica, an independent research company, to conduct the AMA Physician Practice Information Survey. Email recipients are not publicly known and the AMA will not disclose the recipients names. There are two elements to the PPI survey—a financial survey and a physician hours survey. Why This Survey is Important […]

Prevent Interventional Pain Denials and Improve Payments

StreamlineMD is here to provide interventional pain management documentation tips to prevent denials and improve payments.  With continuous declines in physician payments, every detail counts. Update your report templates/macros. Ensure that your documentation is clear and concise, and consistent with CPT 2024 code language. Why Insurance Carriers Deny Claims: Insurance carriers’ business model is to […]

Vertebral Fractures – Proper Documentation & Coding

The various image-guided percutaneous procedures used to treat Vertebral Fractures include terms such as Vertebroplasty, Kyphoplasty,  Sacroplasty and Augmentation.  The nuances of these procedures often cause confusion. This article discusses these procedures, their documentation, and CMS policy to obtain more clarity.

StreamlineMD Releases New Client Portal

We are excited to announce that StreamlineMD will be rolling out new features, allowing you to access security request forms & training videos online through our new StreamlineMD Client Portal. 

Prepare for MIPS/MACRA 2023

It’s that time again to make sure your practice is on track for reporting MACRA/MIPS for 2023.  Below are some resources to assist you in understanding the MIPS/MACRA requirements for 2023.