2022 May Coffee Chat-video1245873072

Video Transcription

Video Summary

Summary: The coffee chat session began with introductions and an invitation for participants to ask questions or share comments. Dr. Amir Termizi led the chat and started by addressing a question about physician billing audits. He explained that some Medicare administrative contractors, such as CGS, have issued denials for physician visit bills, especially for patients receiving general inpatient care (GIP). The medical director's perspective was also shared, emphasizing the need to clearly document medical necessity for physician visits and ensure that they meet the requirements for an E&M visit code. The discussion then shifted to the topic of billing for inpatient hospice visits in a hospital setting. Various approaches were shared, including separate billing for face-to-face visits and regular compliance visits, and the need to clearly document medical necessity. The issue of diagnosis coding for dementia patients was also discussed, with several options mentioned, such as senile degeneration of the brain and cerebral atherosclerosis with vascular dementia. The conversation then turned to the auditing of physician visits and the use of specific diagnostic codes. It was acknowledged that there is a need for more clarity and consistency in these areas. The chat concluded with a discussion about benchmarking compensation structures for hospice and palliative care providers. It was mentioned that while there is a need for up-to-date data, comprehensive surveys may be challenging to conduct, given the diversity within the field. Alternative resources and organizations such as MGMA were suggested as potential sources of compensation information. Additionally, the need for more specific prognostication tools for conditions like COPD and dementia was raised, with participants sharing their use of tools such as ADEPT and the Mortality Risk Index. The session ended with an invitation to share medication agreements and a reminder to provide email addresses for further communication.

Keywords

coffee chat session

physician billing audits

Medicare administrative contractors

denials

E&M visit code

inpatient hospice visits

diagnosis coding

benchmarking compensation structures

diversity within the field

prognostication tools