decisionhealth Newsletters, Coder Pink Sheets - 2018 Issue 1 (January)
Keep track of time to seize payment for new add-on codes to preventive services
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Article Overview
This article covers a 2018 Medicare payment update that introduced new prolonged service add-on codes for certain preventive encounters. It focuses on how CMS tied those add-on services to assigned time values across covered preventive services, why the change matters for payment accuracy, and which types of preventive visits and screenings are affected. The piece is aimed at coders, billers, and practices that report Medicare preventive services and need to understand the scope of the new guidance.
Why This Topic Matters
The article is relevant because it affects how practices track time, report prolonged preventive service add-ons, and recognize which preventive encounters may qualify under the updated Medicare framework.
Article Sections
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Introduction to the new preventive service add-on codes
Introduces the 2018 Medicare update and the general purpose of the new prolonged service add-on reporting pathway for preventive encounters.
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CMS final rule context and payment intent
Summarizes CMS’ rationale for creating the new reporting opportunity and the broader payment context described in the final rule.
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Time tracking and valuation for preventive encounters
Describes how CMS assigned time values to covered preventive services and why careful time tracking is relevant for these encounters.
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Applying the add-on codes to preventive services
Discusses the relationship between the preventive service time values and the new add-on reporting framework, including the general timing concept used in the article.
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CMS valuation table for 18 preventive services
Presents the list of Medicare-covered preventive services referenced in the article and their associated typical time values.
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Split the codes among services
Addresses reporting of extra time when multiple preventive services occur during the same encounter and summarizes CMS’ clarification on cumulative time.
What You Will Learn
- How CMS updated reporting options for prolonged time associated with preventive services
- Which general categories of preventive encounters are included in the 2018 update
- How CMS’ time valuation framework affects preventive service reporting
- How multiple preventive services in one encounter are addressed at a high level
- Which Medicare-covered preventive service types are referenced in the article
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Primary care practices
- CMS/Medicare-focused compliance staff
Codes Discussed
Code Ranges Discussed
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