Practice Management
It’s again time to review what has changed with the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) effective October 1, 2017 through September 30, 2018. There are 360 new, 142 deleted, and 226 revised diagnosis codes in the final update. We will review the changes most relevant to urgent care, but the examples shown here are not all-inclusive. You can find all updates in the Centers for Medicare and Medicaid Services (CMS) website …
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Recent headlines have put Medicare fraud—and the search for those committing it—in the spotlight. However, urgent care clinicians who toe the line in treating Medicare patients are less likely to face unwarranted audits in the future—while fraudsters are putting themselves more at risk than ever—under a new system revealed by the Centers for Medicare and Medicaid Services (CMS). The agency is essentially narrowing the scope of practices it will investigate for fraud, hoping it will …
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The Centers for Medicare and Medicaid Services says providers have been clamoring for an update of the 1995 and 1997 guidelines for evaluation-and-management (E/M) codes—and it may be ready to oblige them. If it goes forward, the plan would take years to implement and focus mainly on revising the history and physical exam portion of a patient encounter. The aim, according to CMS, would be to simplify and better align E/M coding and documentation, presuming …
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Hospital-owned urgent care centers—many of which became “hospital-owned” thanks to a relatively generous 50% reimbursement rate for off-campus patient visits—may be taking a substantial hit if the Centers for Medicare and Medicaid Services follows through on a plan to cut that rate by half. Hospital administrators say even though running off-campus clinics increases their operating budgets, they enable health systems to offer more patients access to cost-effective care. On the other hand, the Trump administration …
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Food and Drug Administration Commissioner Scott Gottlieb, MD says his agency needs to do more to help stem the opioid-addiction epidemic in the United Sates. For starters, he wants the FDA to impose stricter guidelines for prescribing immediate-release opioid drugs. The first step will be for the agency to expand training for physicians, nurses, and other providers who administer immediate-release opioids. While there is already training available, the FDA says it will now broaden information …
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Trustees for the actual Medicare trust fund say it will be insolvent by 2029, a year later than predicted by the Obama administration last year. The year before that, the Congressional Budget Office foresaw the program running dry in 2026. This means the infamous Independent Payment Advisory Board—devised by the designers of the Affordable Care Act (ACA, or “Obamacare”) to put the brakes on Medicare spending if costs grew faster than a predetermined rate—will not …
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Here’s what we know: The Centers for Medicare and Medicaid Services (CMS) is going to stop including Social Security numbers on Medicare ID cards. Here’s what we don’t know: How this is going to work, and how it’s going to affects healthcare providers. The Medicare Access and CHIP Reauthorization Act requires CMS to remove Social Security numbers from Medicare cards due to increasing risk for identity theft and fraud. The year-long process of issuing new …
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The Centers for Medicare and Medicaid Services’ plan to transition from a Social Security number-based ID system to a randomly generated identifier is moving forward. The agency won’t start mailing new cards until April 2018, and the whole process will take nearly 2 years to complete, but in the meantime CMS is rolling out a provider- and patient-awareness campaign to assure the transition is as smooth as possible. The new Medicare beneficiary identifier (MBI) will …
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Urgent care has taken root, among other reasons, based on its capability to treat patients who otherwise would be sitting (and waiting) in local hospital emergency rooms with nonemergent illness and injury. This benefits not only our industry and the patients who need urgent care, but also those patients who will find a less-crowded ED than they might find in a world without urgent care. And some of them—particularly those covered by Medicare and Medicaid, …
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The Centers for Medicare & Medicaid Services is going to issue new Medicare cards, replacing beneficiaries’ Social Security numbers with unique ID numbers, by April 2019. However, the Health & Human Services Advisory Panel on Outreach and Educations says CMS isn’t doing enough to share more about the process with healthcare providers, who will have to make significant changes in their billing practices as the new ID card system is implemented gradually; CMS will start …
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