Tag: American Medical Association

Physician Discovers Hidden prior authorization Details in CPT Codes

Physician Discovers Hidden prior authorization Details in CPT Codes

A proposal to track prior authorization using CPT codes was pulled back for revision after a surprising finding. An urologist, advocated for the plan to compensate physicians for time spent on prior authorization requirements. He also hoped it would streamline the process and improve patient care. However, the American Medical Association (AMA) informed urologist that […]
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CMS Unveils Contentious Prior Authorization Reform Rule Proposals

CMS Unveils Contentious Prior Authorization Reform Rule Proposals

Physicians and healthcare experts are urging Medicare to lead reforms in the time-consuming prior authorization (PA) process, which often causes delays in patient care. However, they caution against excessive reform, as it could exacerbate the problem rather than improving it. The U.S. Centers for Medicare and Medicaid Services (CMS) have put forth two proposals for […]
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AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

Although health plans aim to promote value-based care with prior authorization requirements, providers and patients may experience negative repercussions from the process. Prior authorization negatively impacted patients and providers alike by leading to care delays for patients and creating administrative burden for physicians, according to a survey from the American Medical Association (AMA). Health plans […]
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AMA Has New CPT Codes for Dual Flu-COVID-19 Tests

AMA Has New CPT Codes for Dual Flu-COVID-19 Tests

The American Medical Association updated its Current Procedural Terminology set to include updates to coding for tests that detect influenza and COVID-19. The two new codes, per the AMA’s CPT editorial panel, are: 87636: “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A […]
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EM Code

Final Physician Payment Rule Keeps E/M Code Changes

CMS on Friday issued its 2020 final rules for the Physician Fee Schedule, including a streamlining of evaluation and management services (E/M) reporting that was rolled back from an earlier proposal in a change providers applauded. The final rule, which is mostly unchanged from the proposed rule put forward in July, also cuts payments to physical therapists […]
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Understanding Why 99201 Will be Deleted

Understanding Why 99201 Will be Deleted

An overview of the proposed Medicare Physician Fee Schedule: The proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially released on Aug. 14, 2019, encompassing various elements. Among these are proposals such as adjusting the PFS conversion factor to $36.09, introducing new HCPCS codes for bundled episode-of-care treatment for opioid use disorders, revising […]
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CPT update

CPT 2020 and CPT 2021: Catch a Glimpse

Preview of CPT® Code Changes for 2020 and 2021 The CPT® Editorial Panel’s February 2019 meeting introduced several key updates set to take effect in CPT 2020 and 2021, including significant revisions, deletions, and additions across multiple specialties. Major Changes for CPT 2021 The most notable update is the revision of office and outpatient E/M […]
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