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June 2022


June 2022 

Professional Coding Corner 

Brought to you by PPR 

Summer is officially upon us, and it will surely be an interesting few months ahead as medical practices and rural hospitals continue to struggle with staffing shortages nationwide. When you’re understaffed, it becomes harder to maintain coding and billing compliance, improve patient care quality, increase efficiency, and reduce costs. There are no clear answers. However, information is power, and staying on top of regulatory changes and other industry developments is key. Take a look at these six newsworthy stories we’ve compiled this month. As we look ahead, what are your concerns, and how can Physician Practice Resources help? Email us at info@ppr-corp.com. Most importantly, stay safe out there.  

Community health centers play an important role during COVID-19 and beyond, but challenges remain 

A new report from KFF reminds us of the important role that community health centers have played during the COVID-19 pandemic. More specifically, they provided rapid and PCR tests; administered vaccines; and distributed masks, testing supplies, and oral antiviral pills—all while treating the ongoing health needs of their patients. However, these providers continue to face challenges. For example, lack of Internet access is the number one challenge for community health centers striving to provide telehealth services. In addition, community health centers face new challenges regarding access to and reimbursement from the 340B Drug Discount Program. Finally, recruiting and retaining staff were cited as top overall challenges. What are your biggest challenges, and how can PPR help? 

AMA’s physician recovery plan addresses hot button issues 

The American Medical Association (AMA) recently published a recovery plan that serves as a roadmap to help physicians provide high-quality patient care. It includes these five key goals: 

  1. Supporting telehealth to maintain coverage and payment 
  1. Reforming Medicare payment to promote thriving physician practices and innovation 
  1. Stopping scope creep that threatens patient safety 
  1. Fixing prior authorization to reduce the burden on practices and minimize care delays for patients 
  1. Reducing physician burnout and address the stigma around mental health 

The recovery plan comes in the wake of a recent Medical Economics survey citing payer interference as the number one threat to primary care physicians. Does the AMA’s recovery plan resonate with you, and do you think it will help alleviate payer challenges? Why or why not? 

2023 ICD-10-CM diagnosis code updates bring hundreds of new codes 

CMS recently released its 2023 ICD-10-CM diagnosis code updates that take effect October 1, 2022. Among the changes? Expanded codes for dementia; new codes related to head injuries; expanded codes for long-term drug therapy; new codes for transportation insecurity, financial insecurity, and material hardship; and much, much more. Has your medical practice taken the time to review the changes? What about revising workflows to better capture social determinants of health (SDOH)? Most members of Generation Z say they want their healthcare providers to ask questions about SDOH, a recent survey found. Older patients may feel similarly if it means helping them improve their overall health and well-being.  

Know when to bill preventive and problem-focused E/M services at the same time 

There’s a long-standing myth out there: Physicians can’t ever bill preventive services and problem-focused E/M services during the same patient encounter. In this article, the AMA reminds us this simply isn’t true. Consider this excerpt from the article:  

In the case of billing for both preventive and problem-focused E/M services in the same visit, the significance of the problem addressed, and the amount of time and medical decision-making required help determine how the services are most appropriately billed. 

Might your practice be under-coding these cases? An audit can help. Contact PPR for more information. 

Gain control of your patient portal to increase efficiency 

A recent study found that patient portal inbox messages have risen by 157% since 2020. It’s no wonder why many physicians have felt burned out. Have you felt the same way? If so, check out this AMA article in which various contributors discuss how they’ve been able to minimize the burden and leverage the portal for greater efficiencies. While you’re at it, be sure to also read this guide from AHRQ on how medical practices can use data to improve healthcare quality. One section of the guide is devoted to using the portal and other engagement technologies for quality improvement. What has your medical practice done to maximize return on investment of the portal? 

Audio-only telehealth. Do you know how to maintain compliance?  

HHS recently released HIPAA-related guidance for audio-only telehealth, and it’s important for medical practices to review the information carefully. Has your medical practice taken proactive steps to ensure compliance before OCR’s Telehealth Notification is no longer in effect? 

About us 

Physician Practice Resources, Inc., founded in 2002 and headquartered in Midlothian, IL, is a full-service company that partners with small and large healthcare organizations to build solutions that enhance operational effectiveness, improve clinical documentation, and decrease overall compliance related risks. Contact us at https://www.ppr-corp.com/about-ppr-corp/ for more information. 








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