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Log In SubscribeHelp Advanced Search ◄ Home News & Analysis PBN Current Issue PBN User Tools PBN Benchmarks Ask a PBN Expert Archive NPP Report Archive PPP Archive Regulations & Guidance Coding Resources Fee Schedules Medicare Transmittals Medicare Manual Communities Editors’ Blog Twitter Facebook Training & Events CEUs Store Use 4 team-based care scenarios to refresh your billing knowledge By: Julia Kyles, CPC Medicare’s rules for incident-to and split/shared services give your practice the opportunity to gain extra revenue for a non-physician practitioner’s (NPP) work. But the chance to receive 100% of the physician payment when an NPP does all or some of the work for an encounter comes with the risk of significant pain if members of your practice, including physicians and NPPs, don’t follow the rules. HIPAA Q&A: Vendor risk management, reproductive health care, and telehealth By: Julia Huddleston, CIPP/US, CIPM, CCSFP In this issue, welcomes compliance expert Julia Huddleston, CIPP/US, CIPM, CCSFP, principal with Apgar & Associates, to answer a series of questions about HIPAA compliance areas, focusing on vendor risk management, reproductive rights and telehealth policies. The Q&A session is below. FTC’s labor-market rule ends most noncompetes for physicians, if it clears By: Roy Edroso On April 24 the Federal Trade Commission (FTC) unveiled a final rule that essentially ends noncompete agreements of the sort that allow medical organizations to keep employed physicians from working for their competitors after they leave. While legal challenges from pro-business interests promise to tie the rule up for a while, it’s vital to know what the rule does and does not prohibit. Features Ask a Expert Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, an independent medical coding education consultant, answers some of the many questions she receives pertaining to physician coding for CPT orthopedic serv... More NPP Report Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More Benchmark of the Week A clarification to the rules for split or shared billing took effect Jan. 1, and a look back at the most-billed codes in claim year 2022 reveals the most frequent locations and types of encounters tha... More Ask a Expert Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, an independent medical coding education consultant, answers some of the many questions she receives pertaining to physician coding for CPT orthopedic serv... More NPP Report Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More Benchmark of the Week A clarification to the rules for split or shared billing took effect Jan. 1, and a look back at the most-billed codes in claim year 2022 reveals the most frequent locations and types of encounters tha... More choose your feature view ► May 6, 2024 Legal expert gets specific on exemptions to the FTC’s noncompete rule by: Roy Edroso Apr 26, 2024 After FTC rule bans noncompetes, legal expert discusses impact on health care by: Roy Edroso Apr 10, 2024 Breaking: More than 250 new ICD-10 codes proposed for Oct. 1 by: Megan Herr and Julia Kyles, CPC Tools Give providers an illustrated guide to the new SDOH risk assessment code Make sure your physicians and qualified health care professionals (QHP) are ready for their crucial role in reporting G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment tool, 5-15 minutes, not more often than every 6 months). Cultivate Medicare prolonged service rule compliance with a decision tree Use this decision tree to illustrate Medicare’s rules for coding prolonged E/M services. Medicare created codes and rules for prolonged services performed by a physician or qualified health care professional (QHP) because it disagrees with portions of the CPT guidelines. See more... Benchmark of the Week Subsequent hospital codes top combo with split/shared modifier A clarification to the rules for split or shared billing took effect Jan. 1, and a look back at the most-billed codes in claim year 2022 reveals the most frequent locations and types of encounters that groups should keep a close eye on. Advance care denials dropped as utilization surpassed 2.4M claims Practices have learned to avoid coding mistakes that trigger denials of advance care planning (ACP) services ( 99497-99498 ). The time-based services were introduced in 2015 and Medicare covered the codes in 2016. See more... Learning Opportunities VIRTUAL Advanced Specialty Coding Virtual Summit: Orthopedics VIRTUAL Advanced Specialty Coding Virtual Summit: Pain Management See more... 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Copyright Copyright ©2010 DecisionHealth. All rights reserved. Do not duplicate or redistribute in any form. Users are granted the right to print out any article and/or newsletter found on the site for individual, personal use. This does not convey permission for commercial use or for making multiple copies for uses internal or external. Use of this web site evidences agreement with these restrictions. Trademarks The trademarks, service marks and logos of DecisionHealth, its product-specific brands, or others used on this are the property of DecisionHealth or its respective owners. You may not use any trademark displayed on the site without the written permission of DecisionHealth or its respective owners. Please accept the terms and conditions for use of the web site. I Accept the terms and conditions Change Password Your new password should have at least 6 characters. Current Password New Password Confirm Password Results Poll Results How should CMS proceed with E/M services? 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