The proposed rule for 2019 was released on July 12, 2018. Meridian Medical Management posted a high overview of proposed changes to Payment Policies under the Medicare Physician Fee Schedule. There are also changes proposed for the Quality Payment Program. Amongst the proposed changes are: Changing the definition of MIPS eligible clinicians to include physical therapists, occupational therapists, clinical social workers, and clinical psychologists. Having a third element of the low-volume threshold determination by adding...

The proposed rule that will affect some payments under the Medicare Physician Fee Schedule and/or payment methodologies was released by CMS on July 12, 2018. This is a high overview of some of the changes; all clients should review the proposed rule to identify any categories that may affect them. Once the proposed rule is published on July 27, 2018 the comment period will be open until September 10, 2018. All comments must be submitted...

2017 Final MIPS Performance Feedback is now available. Special scoring circumstances and all MIPS data submitted or calculated for an individual clinician, group, or APM Entity will be reflected. Final MIPS Performance Feedback includes the 2017 Final Score, 2019 Payment Adjustment Information, and details about measures and activities. Clinicians that participated in either track of the 2017 Quality Payment Program, MIPS or APMs, may now access feedback reports on their 2017 Performance Reporting. CMS has completed...

The Center for Disease Control released the 2019 ICD-10 CM codes which are effective October 1, 2018 through September 31, 2019. The release includes 279 new codes, 51 deleted codes, and 143 revised codes.  As of October 1, 2018, there will be 71,932 active ICD-10 CM codes.   The following chapters have the most changes: Chapter 2: Neoplasms - all 45 new codes in this chapter are related to the upper/lower eyelids right or left eye Chapter...

July brings changes to the 2018 Medicare Physician Fee Schedule Database (MPFSDB).  Changes are effective for dates of service beginning July 1, 2018. PE RVU Imaging Code Changes CPT Code 71045 (radiologic examination, chest, single view, frontal) and CPT Code 71046 (radiologic examination, chest, two views, frontal and lateral) have changes to the Facility and Non-Facility PE RVUs. 71045 will change to 0.42 and 71046 will change to 0.35. Indicator Change for RHC and FQHC Care Management...

The Centers for Medicare & Medicaid Services (CMS), has announced a name change for the ACI category under the Merit-Based Incentive Payment System (MIPS) to the Promoting Interoperability performance category. Don’t panic! This is not a new performance category, just a name change. CMS feels the name change better reflects their increase focus on interoperability to improving patient access to health information. The 2018 requirements for this category are exactly the same as what was finalized in...

A recent ruling by the Connecticut Supreme Court allows patients, who have suffered losses or harm from the unauthorized disclosure of their protected health information, the right to bring legal action against providers for unauthorized disclosure of their medical records. In this recent Connecticut case, Emily Byrne vs Avery Center for Obstetrics and Gynecology, the patient had exercised her rights under HIPAA to restrict the release of her medical information. Despite this...

The Type of Service (TOS) code for CPT code 77067 for Screening Mammography will be updated to “1” (Medical Care) instead of “4” (Diagnostic Radiology). This will allow for accurate claim submission and adjudication of screening mammography. Correcting the TOS code for CPT code 77067 allows screening mammography claims to be submitted and adjudicated appropriately with no referring physician information on the claim, this is consistent with Medicare’s coverage policy for screening mammograms. Be aware that MACs...

In 2017 MACRA revoked the Sustainable Growth Rate (SGR) formula and introduced the Quality Payment Program; a payment program based on quality of care and not quantity.  The Quality Payment Program assesses clinicians on a range of performance categories including the cost category. MACRA requires the development of patient relationship categories and codes for possible use in the methodology for the cost measures. A fact sheet on the cost category can be found at https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2018-Cost-Performance-Category-Fact-Sheet.pdf   Specifically, the...

Medical billing firm utilizes Meridian Robotics to enhance efficiency for client practices across nine states WINDSOR, Conn.,  May 3, 2018 (GLOBE NEWSWIRE) – Meridian Medical Management announced today that HuTech Resources, a leading healthcare practice management, consulting and medical billing firm working with practices in nine states, has selected Meridian Robotics to automate its billing center. Meridian Robotics will aid HuTech in serving its customer base of physicians, improving efficiency and productivity within the medical billing...