Effective January 1, 2018, payments for imaging services that are X-rays taken using computed radiography (including the technical component portion of a global service) provided during CY 2018, 2019, 2020, 2021, or 2022, will be decreased by 7 percent. For CY 2023 and subsequent years, payments will be decreased by 10 percent for these services. Computed radiography technology is defined as cassette-based imaging which utilizes an imaging plate to create the image involved. A new modifier...

Just when you think you have a proficient grasp on the new CMS Quality Payment Program-The Merit-based Incentive Payment System (MIPS) has changes in store for January 1, 2018.  There are some helpful changes such as an increase to the “Low-Volume threshold” and additional points being awarded for improvement in the Quality and cost category to name a few. There are some other changes however, that necessitate your attention such as needing a higher score...

CPT changes go into effect on 1/1/2018. A few highlights for frequently used categories are noted below. Please refer to the spreadsheet link here to review all code additions, deletions and revisions. The spreadsheet includes a summary tab and additional tabs separated by specialty. For ease of review, the code change category is noted in Column A. Radiology CPT codes 71010-71035 for x-ray of chest are being deleted and replaced with the following four CPT codes and...

Closure of NOPR (NaF-PET) on December 14, 2017  On December 15, 2015, The Centers for Medicare & Medicaid Services (CMS) issued a final decision memorandum http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=279 pertaining to the coverage of bone PET with F-18 sodium fluoride (NaF-PET) to identify bone metastasis. This National Coverage Decision (NCD) extended the requirement for coverage with evidence development (CED) under §1862(a)(1)(E) of the Social Security Act for NaF-18 PET to identify bone metastasis of cancer contained in section 220.6.19B of the...

Medicare’s Merit-based Incentive Payment System (MIPS) program recently passed an important milestone: October 2 was the date by which providers must have begun collecting – but not reporting – quality measures to be eligible for a MIPS bonus in 2019. While the calendar has already moved past that date, it is likely that many providers still have not taken the steps necessary to succeed under these new regulations imposed by the federal government. A number of...

Some Important Changes It is that time of year when we are all awaiting colder weather and anticipating the release of the final rule for CY 2018 PFS! CMS finalized revisions to payment policies under the physician fee schedule along with other revisions to Part B for the calendar year of 2018. The 2018 final rule is scheduled for publication in the Federal Register on November 16, 2017.  Below you will find some highlights to some...

The wait is over! The final rule with comment period is to be published November 16, 2017! There are some changes to reporting period 2018 (year 2), but many flexibilities will remain the same as CMS wishes to proceed slowly to prepare clinicians for full implementation in year 3. Below are some highlights to the 2018 final rule as it pertains to the Quality Payment Program. This is not an all-inclusive list and Meridian Medical Management...

Medical group will utilize analytics and robotics to improve revenue cycle efficiency   Windsor, CT – October 24, 2017 (GLOBE NEWSWIRE)– Meridian Medical Management announced today that North Texas Orthopedics & Spine Center has selected Meridian to provide revenue cycle management. As part of this initiative, North Texas Orthopedics will utilize Meridian’s robotic process automation and PrecisionBI analytics engine, which will further increase the benefits gained – aiding in more revenue being realized faster.   “North Texas Orthopedics...

Information you’ll need to know regarding program year 2017 Modified Stage 2: You must attest for program year 2017 no later than midnight on March 31, 2018 All eligible professionals (EPs) must attest using EHR technology certified for 2014 or 2015 or a combination of both All providers are required to attest to a single set of ten objective and measures The EHR reporting period for Meaningful Use and Clinical Quality Measures (CQMs) is 90...

The 2017/2018 Influenza Season is starting! Are you ready to code accurately to be reimbursed correctly? According to the Center of Disease Control and Prevention, receiving an annual flu vaccine is the greatest method in protecting yourself and those around you from the flu. The more people who are vaccinated the more people will be protected. Who should be vaccinated? All persons should receive the flu vaccine but the following groups are at high risk: Older people and those...