This week’s Medicare updates include the first annual report on the Next Generation Accountable Care Organization model, a Special Edition MLN Matters article on when to review opioid use with beneficiaries, the introduction of a new way for Part D plans to manage formulary designs and options, and more!
Patient matching—associating the right patient with the right medical record—isn’t a new problem, but as the practice of medicine and reimbursement models become more data-driven, the stakes will continue to rise.
The professional case manager and nonlicensed case manager extender relationship is a valuable partnership. The nonlicensed case manager extender is able to assist the patient and follow the patient’s individualized plan of care with the guidance of the professional case manager.
Modifiers -25 and -27 are used in the outpatient facility setting on E/M services. Learn more about how these modifiers should be applied in accordance with coding and Medicare guidelines.
To effectively report opioid use, abuse, and dependence, coding and billing professionals must be able to recognize symptoms of these disorders and interpret detailed ICD-10-CM guidelines. Additionally, they must be able to identify complications associated with opioid misuse and overdose.
