By
I have whined in a previous RACmonitor enews article about how the importance given to the admission order in today’s healthcare industry makes absolutely no sense. It’s not an order for a medication or a test, wherein if it is transcribed incorrectly, the patient could be physically harmed. The admission…
By
CMS engages in lively discussion about the proposed 2019 MPFS. The Centers for Medicare & Medicaid Services (CMS) was asked yesterday by a listener if the agency considers their proposal to change the method of selecting the E&M code by using time, medical decision-making, or the current system and the change to…
By
2019 E&M changes will impact all areas of practice management. Far-reaching impacts to work relative value unit (RVU)-based compensation models that will pay providers in full or part are expected if the Centers for Medicare & Medicaid Services’ (CMS’s) proposed evaluation and maintenance (E&M) changes become a final rule. In…
By
The proposal would present a dangerous precedent for all of medicine. On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule on the 2019 Medicare Physician Fee Schedule (CMS-1693-P). In what they say is an attempt to reduce physician burden, CMS is proposing to…
By
Condition 44 is one of three perplexing issues reviewed by the author.  Last week was a boring regulatory week, other than the continuing talk about the proposed changes to evaluation and management (E&M) coding. That continues to dominate discussions, with ongoing negativity by the physician community. Without new regulatory controversy,…
By
Practices need to get a handle on both their financial and RVU impacts. Recently, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that would change the face of evaluation and management (E&M) codes as we have known them. Since 1992, E&M codes have been leveraged to…
By
The proposal is on the table as part of proposed E&M changes. By now I am sure that everyone is well aware that the Centers for Medicare & Medicaid Services (CMS) has proposed modifications to the reimbursement model for the outpatient/office evaluation and management (E&M) code sets, as well as…
By
Skilled service must be is reasonable and medically necessary on a daily basis. Years ago – when I was first entering healthcare and pilgrims were coming over on the Mayflower – the Centers for Medicare & Medicaid Services (CMS) initiated a sea change in the manner in which skilled nursing…
By
CMS is proposing major changes to overhaul E&M services. As I read through more and more articles and white papers on the new proposed 2019 evaluation and management (E&M) changes, I got more rather than less confused. It feels like the Centers for Medicare & Medicaid Services (CMS) had this…
By
Change to the inpatient admission order considered to be major. Late last week, the Centers for Medicare & Medicaid Services (CMS) released the Inpatient Prospective Payment System Final Rule, which becomes effective on Oct. 1. It’s 2,593 pages, so get reading. I have to commend the CMS staff for their…