Business Support Network Launched to Help Business Administrators It’s not unusual for neurology practice business administrators (BAs) to have questions or need advice about matters that come up during the workday. To help connect them with fellow BAs who might have the answers they seek, the AAN is debuting the Business Support Network. The network is comprised of six AAN business administrator members representing a variety of practice settings and areas of expertise. They are available to help answer practice-related questions and share their experiences related to various topics and scenarios. The Academy hopes BAs find this resource a meaningful way to build their professional networks and get support to help their practices thrive. To reach this network, email practice@aan.com. This inbox is monitored by AAN staff who usually respond within one business day. Staff also can help answer practice-related questions regarding practice management and operations, coding, the quality payment program, payer issues, and more. When staff reach out to the Business Support Network, questions are
Business Support Network Email practice@aan.com to: Reach business administrator network Get your practice-related questions answered Build your professional network
stripped of identifying information for anonymity. In this way, BAs are free to ask potentially sensitive questions. Staff compile network insights and email back the inquirer, including network contact information when appropriate. The Business Support Network is an expansion of the AAN’s successful Practice Support Network comprised of physician graduates of the Practice Leadership Program who also help answer questions submitted to the practice@aan.com inbox.
Navigating E/M Coverage in 2021 2021 brought about the most significant changes to the way outpatient E/M services are reported in over 20 years. As we get further into the year, questions have arisen concerning private payers’ audit procedures for outpatient E/M under the new documentation guidelines. While many payers are working through new workflows and are trying to figure out the exact way they will audit these services, the AAN continues to communicate with them to understand their auditing process.
The Coding and Payment Policy Subcommittee has compiled some helpful tips for working with payers: When billing based on time, remember to include total (both face-to-face and non-face-to-face) time on the day of the encounter. As the revised documentation guidelines do not stipulate specifically how time is to be captured in the medical record, take note of any payer-specific requirements. When coding based on medical decision making (MDM), we recommend not to include time in your documentation. If time is documented, payers may misinterpret this as time-based billing and this could result in delayed claims processing or denials. Also new in January 2021 were prolonged service codes 99417 and G2212 for time spent beyond the standard level 5 outpatient visits. While both codes are used for increments of 15 minutes
of additional time, it is important to note the threshold to report each code differs as does payer coverage of each code. When submitting a claim for prolonged services it is imperative to first check with your payer to see what codes are covered, in addition to which type of policy the patient has. Medicare Advantage plans generally follow Medicare guidelines and will cover G2212, whereas commercial payers may be able to accept either code G2212 or 99417. It always is recommended to review your payers’ policy regardless of Medicare Advantage, Medicaid, or commercial payer or check with your provider representative to see what codes they can accept. The AAN is here to help our members navigate any potential claims denials and help them identify options for submitting a corrected claim or appeal. Contact AAN staff at practice@ aan.com for answers to your questions concerning outpatient E/M coding, payer relations, and to share your experiences with payers that might benefit your neurology colleagues.
Prolonged Service Codes 99417 and G2212
99417: Prolonged office or other outpatient evaluation and management service(s) beyond the minimum required time of the primary procedure which has been selected using total time, requiring total time with or without direct patient contact beyond the usual service, on the date of the primary service, each 15 minutes of total time G2212: Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact