The Centers for Medicare & Medicaid Services’ (CMS’s) proposed evaluation and management (E&M) code changes in the recently posted 2019 Medicare Physician Fee Schedule continue to generate controversy. The controversy centers around the proposal by CMS to reimburse new patient visits at a single flat rate for codes 99202-99205 (99201 would be paid at a lower rate), while a corresponding, lower flat rate would apply to established patient visit codes 99212-99215. Code 99211 would also be paid a lower rate. The level 1 codes don’t get the flat rate, because they don’t require the presence of a physician.

Reporting this developing story during this edition of Monitor Mondays will be Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS) as well as president of coding and billing services and a partner at DoctorsManagement, LLC.

The broadcast rundown also will include:

• Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment.

• Monday Focus: Lori O’Hara, the lead of the additional documentation request (ADR), appeals, and clinical review team for Ensign Services, a provider of skilled nursing and assisted living services, reports on the impact of the Inpatient Prospective Payment System (IPPS) final rule as it pertains to skilled nursing facilities.

• Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, reports on all the latest hot topics and present the Monitor Mondays Listener Survey.

• Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron reports on another example of a potentially troublesome issue that could pose a risk to your facility.
  
  
• IRF Report: One of the nation’s most respected authorities on Inpatient Rehabilitation Facility (IRF) provider issues, Angela Phillips, president and chief executive officer for Images & Associates, reports on IRF provisions that will be impacted by the IPPS final rule.

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