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CMS’ newest program aims to facilitate value-based payment participation. The Centers for Medicare & Medicaid Services (CMS) has a new goal: Get 100 percent of traditional Medicare beneficiaries and most Medicaid beneficiaries into accountable care relationships by 2030. Strengthening the U.S. primary care infrastructure has been an ongoing project for CMS, and they aim to […]
The post Making Care Primary: Strategic Support for Accountable Care appeared first on AAPC Knowledge Center.
CMS selects primary care payment model participants
According to Becker’s Hospital Review, “CMS chose 916 primary care practices and 37 regional health plan partners as participants in its new payment model called Primary Care First.
PCF was designed to decrease the amount of avoidable hospital visits and total cost of care through performance-based adjustments. The practices CMS selected as participants generally include primary care clinicians who serve seriously ill populations in high need of care.
Participants will start using the alternative payment model Jan. 1, 2021, and CMS plans to test the model for five years.”
The post CMS Selects Primary Care Payment Model Participants appeared first on The Coding Network.
Direct primary care (DPC) is one of the newer forms of plans offered by primary care providers to their patient populations. Some see DPC as an alternative to traditional third-party payment for care and other more recent models such as concierge medicine. Primary care providers are tired of the consumable resources required to submit claims […]
The post Is Direct Primary Care the Answer? appeared first on AAPC Knowledge Center.
CMS’ Innovation Center is propelling an activity that gives Primary Care Practices five new installment alternatives, including three direct contracting models.
Click Here to Read Six Important Things to Know!
The post CMS uncovers 5 new installment models to redesign Primary Care appeared first on The Coding Network.
Beginning January 2020, primary care practitioners may qualify to participate in one of five new payment model options that focus on supporting care for patients who have chronic conditions and serious illnesses. The Centers for Medicare & Medicaid Services’ (CMS) Primary Care Initiative is a new set of payment models that will provide primary care […]
The post CMS Is Putting Primary Care First appeared first on AAPC Knowledge Center.
My inclination was to code secondary hypertension, e.g., I15.8 Other secondary hypertension (although I’m not sure how I would report left ventricular noncompliance or aortic inelasticity). However, another coder stated that, since the assessment indicates "blood pressure well controlled," I should simply report I10.
Is this good advice? If so, why? Is it because it’s well controlled (doubt that’s a good reason), or is it simply because in the assessment, the doctor chose not to characterize the hypertension as secondary?
Thanks,
Jim Shaw, CPC-A
Can a primary care physician, i.e., family practice, submit the following CPT Cat II codes to close HEDIS gaps in care if they receive an eye exam report for their diabetic patients (from an eye care professional), review the report and place it in the patients medical record?
2022F: Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed
2024F: 7 standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist documented and reviewed
2026F: Eye imaging validated to match diagnosis from 7 standard field stereoscopic photo results documented and reviewed
3072F: Low risk for retinopathy (no evidence of retinopathy in the prior year)
Thanks for reviewing this!
Yvette Peak
If hydration was the primary code, then it would be 96360 and 96361.
Thanks