HCC Blog by Caridad

Listed below are place of service codes and descriptions.  These codes should be used on professional claims to specify the entity where service(s) were rendered.  Check with individual payers (e.g., Medicare, Medicaid, other private insurance) for reimbursement policies regarding these codes. https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set.html

Announcement of Calendar Year (CY) 2018 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter and Request for Information April 3, 2017 for CY 2018 Page 64 https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2018.pdf Table VII-5. List of Disease Hierarchies for RxHCC Model

Reducing Opioid Misuse from CMS. They are focused on three main areas: Prevention, Treatment and Data.  Click on link below to access page and then click on 'See our roadmap." https://www.cms.gov/about-cms/story-page/reducing-opioid-misuse.html As of August 28, 2018,  from the MLN Matters Number: SE19004, Medicare would like to include opioid use in the 'Review of Medical and Family History' element of the AWV. Providers are encouraged to pay close attention to opioid use during this element of the AWV. If a patient is using opioids, assess the benefit from other, non-opioid pain therapies instead, even if the patient does not have Opioid Use Disorder bus is possibly at risk. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE18004.pdf Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the auth...