Coding It Right
The NCCI program includes two
types of edits: NCCI edits (also known as Procedure to Procedure (PTP) edits)
and Medically Unlikely Edits (MUEs) (Units of Service). ... Each PTP edit has a
column one and column two HCPCS/CPT code and a Correct Coding Modifier Indicator (CCMI).
Quality
Measures
Transition Year 1
Exclude individual MIPS eligible clinicians or
groups who bill <$30,000 in Part B allowed charges OR provide care for
<100 Part B enrolled beneficiaries during the performance period or a
prior period.
Note: For the 2017 and 2018 MIPS performance
periods, individual MIPS eligible clinicians and groups who are excluded may voluntarily
participate in MIPS, but would not subject to the MIPS payment adjustments.
Year 2 Transition
Exclude MIPS eligible clinicians or groups who
bill <$90,000 in Part B allowed charges OR provide care for < 200 Part B
enrolled beneficiaries during the performance period or a prior
period.
Note: Starting with the 2019 performance
period, individual MIPS eligible clinicians and
groups who are excluded, but exceed one of the
low-volume thresholds, would be able to optin
to MIPS and be subject to the MIPS payment
adjustments.
CPT
II Codes
It provides an
overview of the performance measures, a listing of CPT Category II codes that may be used with each
measure, as well as any applicable reporting instructions.
Have you
captured the appropriate ICD-10 , to meet the HCC Coding?
Did you code to
indicate the appropriate measure has been performed?
Have you chosen
the correct E&M level of service?
Is it under coding or over coding?
Is the practice
in compliance with all FEDERAL / STATE / LOCAL requirements?
We are a
consulting firm helping physicians and payers since 1983. For more
details regarding this article or about our services , please feel free to
contact us at :
SILBEN Healthcare Services, INC.
Paul G. Silverio-Benet
Phone: 305-975-1171
No comments:
Post a Comment