There is a great deal of consternation amongst physician practices as it relates to MIPS/MACRA. While it is certainly complex and confusing, understanding the requirements and participating wholeheartedly may prove to be a real opportunity to increase reimbursement in a material way.
While CMS rules regarding billing for physician extenders, including Physician Assistants (PA) and Nurse Practitioners (NP) and other Non-Physician Providers (NPP), have been published and consistent for several years, it is common to find practices that do not know or follow them. The purpose of this letter is to simplify the rules to help keep practices in compliance with CMS guidelines. This letter specifically covers rules for billing for an extender that is enrolled with CMS versus not enrolled, and when it’s appropriate to bill the extender as “Incident to”.
Currently, for most of the interventional procedures you perform, reimbursement for moderate sedation is bundled into the procedure code, but that will soon change. For dates of service on or after January 1, 2017, reimbursement for the procedure and the moderate sedation will be separated.
Below is a summary breakdown of the critical steps to comply with the MACRA QPP MIPS program as a Vein Center practice...
As anticipated, significant updates were made to the ICD-10-CM Coding Guidelines for 2017. These guidelines are a set of rules developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. These guidelines are located in the front of the 2017 ICD-10-CM Coding book. Be sure to take a look at the date at the beginning of the guidelines, if it doesn’t state “FY 2017” then download the current version at 2017 ICD-10-CM Official Guidelines for Coding and Reporting
The final rule with comment period for Quality Payment Program (MACRA) was released on Friday, October 14, 2016. Now what do I do?
One of my customers recently forwarded an article to me from the March 3rd, 2016 issue of the New England Journal of Medicine. The article titled Uber’s Message for Healthcare and authored by Alan Detsky, M.D. and Alan Garber, M.D., struck a chord because it was introducing the concept of disruption from a business model perspective in the healthcare industry. While the article was quick to point out the vast differences between healthcare and taxi services, the conclusion arrived at by the authors is well represented by the following excerpt from the commentary:
StreamlineMD and Vidistar have partnered to offer a fully integrated EHR/PACS solution. The integration enhances the StreamlineMD U/S Drawing Tool by facilitating the autopopulation of data from the imaging modality.