Participation in the Quality Payment Program (QPP) means that you always have several years’ information in play at one time. The score you earned from submitting 2018 data will now be impacting your Medicare reimbursement in 2020; you have just completed your 2019 performance and it’s time to submit your data; and finally, you now have to begin your 2020 performance year.
Categories: cms, MIPS, Quality Payment Program, MIPS participation, QPP, quality measures
In the final 2020 Medicare Physician Fee Schedule (MPFS), fee increases relevant to radiology overall outnumbered decreases. However, many of those increases were insignificant changes of less than 1%. There were 128 Professional Component (PC) codes decreased by more than 1%, with only 76 increased, while 430 Global codes increased by more than 1% and 346 Global codes decreased. Here are the details:
Categories: radiology reimbursement, radiology billing, medicare reimbursement, MPFS, interventional radiology billing
It’s a cold January here in the northeastern US, so it’s a good time to heat up plans to comply with the Medicare AUC Mandate! We have entered the official Educational and Operations Testing Period of 2020, which means that Medicare is ready to accept the Appropriate Use Criteria (AUC) modifiers and G-codes on claims now being submitted. Let’s first review what this Medicare mandate means and then make plans to get it operational in your practice.
Categories: radiology reimbursement, medicare, cms, CDS, AUC
Click here to read our 2024 code changes update article.
With the new year comes the annual revision of Current Procedural Terminology[i] (CPT)® coding that practices have to be aware of. For diagnostic radiology, the changes for 2020 are relatively few and they are concentrated in the areas of abdominal and gastrointestinal plain films, nuclear medicine procedures for tumor localization, and myocardial PET imaging. The changes to interventional radiology coding are likewise quite limited and involve pericardial and spinal puncture procedures.
Categories: radiology coding, IR coding, CPT codes
Our own Sandy Coffta, Vice President of Client Services, spoke with Aunt Minnie’s Brian Casey at the 2019 RSNA Annual Meeting in Chicago. In the interview posted on auntminnie.com, Sandy mentioned some of the highlights that practices should be concerned about in the coming year.
Categories: radiology reimbursement, radiology billing, radiology documentation, radiology coding, radiology
In the absence of federal regulation, states are adopting laws intended to protect patients from high out-of-pocket costs when they unexpectedly receive services from out-of-network (OON) providers. When a patient receives an unexpected bill following such OON services the situation is known as “surprise billing.” Not all OON billing falls into the category of “surprise billing,” however. In many cases, patients understand that the services they are receiving are OON and they expect to pay all or part of the bill.
Categories: radiology reimbursement, radiology billing, surprise billing
The Centers for Medicare and Medicaid Services (CMS) has released the annual changes to the Medicare Physician Fee Schedule (MPFS) in its Final Rule that contains not only adjustments to Medicare reimbursement but also revisions to the Quality Payment Program (QPP) for 2020 and beyond. The MPFS Final Rule does not contain very many significant changes for the coming year, especially for radiology, but one of its provisions will have a far-reaching effect on radiology beginning in 2021.
Categories: medicare, medicare reimbursement, cms, MPFS, radiology, QPP, quality measures
The “Patient Test Result Information Act”, or Pennsylvania Act 112 of 2018, will take full effect on December 23, 2019. The Act was originally scheduled to begin in December 2018, but the imposition of citations and fines was delayed for one year. During that time, many hospitals and radiology practices have implemented systems designed to help them comply with this law.
Categories: radiology, clinical analytics, PA Act 112
The 2020 annual update to the ICD-10-CM[i] system used in medical insurance claim billing became effective on October 1, 2019. Twenty-one (21) codes were deleted, thirty (30) codes were revised and 273 new codes were added. The good news for radiologists is that relatively few of these changes will affect your work.
Categories: radiology coding, icd-10
Any physician who has read about the relatively high award in a recent medical malpractice lawsuit has to be thinking about how they can protect their own practice against a similar outcome from a missed communication with a patient or primary care physician. In case you missed it, our recent article describes the lessons learned from this case.
Categories: radiology, clinical analytics
