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After months of feedback from payers and providers unhappy with a proposal to mandate price transparency in healthcare, the Trump administration has now unveiled its final rule on the topic of hospital price transparency. This topic has been in talks for months and its effective date is being pushed to 2021. Declaring “a major victory”…
DetailsOpioid Treatment Programs (OTP’s) have been a hot topic for several years. Among several new codes set to be implemented January 1st are new HCPCS codes specifically for OTP’s. Here are two sequences to be aware of: GYYY1-GYYY3 (office-based treatment) GXXX1-GXX19 (medication-assisted treatment) These new codes will reimburse with bundled payments for the treatment of…
DetailsSince acquiring PillPack in 2018, Amazon has now bought Health Navigator in which they intend to offer to employees of Amazon. Many are certain Amazon will soon enter the healthcare market. Read the article below to find out more about this new acquisition that was made and learn some of Amazon’s goals. In what is…
DetailsAlthough the exact reason for denial was not given for this encounter we know this is considered investigational. Most insurances will not pay, it would have to be unlisted-23929. Click below for more information! As a general rule, benefits are payable under Blue Cross and Blue Shield of Alabama health plans only in cases of…
DetailsState healthcare officials have until November 15 to put together a final “state option” proposal for the legislature. Many are hoping new changes will be implemented due to the rise in healthcare costs. Read the article below to find out more on what legislation may be coming and what the concerns are with this program.…
DetailsRT Welter is providing new information regarding E/M changes in 2020. Read the updates below on what is coming next year for coding, along with changes to PCM and CCM. What’s New for 2020 The CY 2020 PFS conversion factor will increase to $36.0896, up to $0.05 from CY 2019. Three new Telehealth Service codes…
DetailsCMS’ Innovation Center will delay the start of a new payment model called Primary Care First by a year, according to timeline updates on the model’s information page. Primary Care First, announced in April, was slated to begin in January 2020. Now, it will begin in January 2021. The voluntary model is a set of five-year payment…
Details2019 ICD‐10‐CM updates went into effect on October 1st. These changes will impact encounters for dates of service October 1, 2019 through September 30, 2020. It is imperative that your organization has up‐to‐date coding resources and a keen understanding of the changes that will impact your reimbursement! The new updates can also influence your organization’s…
DetailsReactive Hypoglycemia (ICD-10 code E16.1) or a sugar crash can do more than just make you tired. It can lead to feeling of hunger, irritability, anxiousness, headaches or even difficulty concentrating. With Halloween just around the corner, it seems there is a candy dish stocked full of treats everywhere you turn. It’s not just about…
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