PARA Weekly eJournal June 12, 2019

PARAWeekly -

eJOURNAL

PRICING CODING REIM BURSEM ENT COM PLIANCE

NEWS FOR HEALTHCARE DECISION MAKERS June 12, 2019

IN THIS ISSUE

Feat ur ing

QUESTIONS & ANSWERS - Device-Dependent Code Billing Edit - Time-Based Charge Calculations In OR - Billing For Oxygen - PBB Urology Service And Revenue Codes

Ch ir opr act ic Car e

Pr act ice Billin g Requ ir em en t s f or Ch ir opr act or s

MEDICATION ASSISTED TREATMENT FOR SUBSTANCE ABUSE HETS QUERY FOR MEDICARE DIABETES PREVENTION PROGRAM PHARMACY PRICING PROCESS

Page 20

1

The number of new or revised Med Learn articles released this week.

2

The number of new or revised Transmittals released this week.

RURAL HOSPITAL GRANTS -- UPDATED MLN CONNECTS NEWSLETTER NEWS AND COMPLIANCE UPDATES WEEKLY INFORMATION TECHNOLOGY UPDATES

PARA COMPANY NEWS

SERVICES

ABOUT PARA

CONTACT US

FAST LINKS

-

REPORTS: Hospice Pr ovider s Can Preview Report s. Page 21

Administration: Pages 1-31 HIM /Coding Staff: Pages 1-31 Providers: Pages 2,7,11,18 Finance: Pages 2,20,26,28,29 Ambulatory Care: Pages 3,22 Perioperative Care: Page 5 Respiratory Care: Page 6

-

Urology: Page 7 CAHs: Page 7 Pharmacy: Pages 11,22 Chiropractic Care: Page 20 Diabetic Care: Page 18 Rural HealthCare: Page 22 Hospice Care: Pages 21,23

© PARA Healt h Car e An alyt ics CPT® is a r egist er ed t r adem ar k of t h e Am er ican M edical Associat ion

PARA Weekly eJournal: June 12, 2019

DEVICE-DEPENDENT CODE BILLING EDIT

Regarding device-intensive procedures, Medicare is rejecting our claims stating that a device code is necessary. Our HIM department is saying there is no HCPCS to assign for the device and that it should not be required by Medicare. Can you review to see if you feel the claim was coded appropriately based on documentation and if you feel a device HCPCS should and can be reported to bypass the Medicare rejection?

Answer: Your claim reported 28415, OPEN TREATMENT OF CALCANEAL FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED. Since internal fixation is included only ?when performed?, this code is appropriate, even though the treatment did not include an internal fixation device.

There is a problem this year with edits Medicare implemented for ?device-dependent? outpatient procedures ? claims reporting these codes must also report a device code to pass CMS edits.

In the 2019 OPPS Final Rule, Medicare expanded its Addendum P (device-dependent codes) to include any in which a device constitutes more than 30% of the calculated cost of the procedure.

Attached is Addendum P. And here?s an excerpt showing 28415 is on this list:

2

PARA Weekly eJournal: June 12, 2019

DEVICE-DEPENDENT CODE BILLING EDIT

In the 2019 Final Rule, Medicare acknowledged a commenter?s concern that there would be times when no implant would be used for some of the codes on Addendum P. Here?s what they wrote: Comment: Some commenters expressed concern about a potential claims processing issue that would arise from a number of codes (listed below in Table 36) that were proposed to have device-intensive status, which, in their clinical opinion, do not always require the involvement of implantable or insertable single-use devices and, therefore, could be subject to the claims edit requiring device-intensive procedures to be billed with a device., when the procedure may not require the involvement of a device. ? [list of codes] Response: We have noted the commenters?concern. We have performed a clinical examination of the potential device-intensive procedures and believe the codes listed in Addendum P to this CY 2019 OPPS/ASC final rule with comment period (which is available via the Internet on the CMS website) as OPPS device-intensive meet the newly finalized criteria of being a device-intensive procedure. To address any potential claims processing issues pertaining to the device edit policy, we will use subregulatory authority to ensure that the device edit does not improperly prevent correctly coded claims from being paid.

We have been waiting for the promised subregulatory guidance, and we have emailed CMS directly asking this question, but we have received no response and have seen no guidance published on this matter.

There is Medicare guidance for other similar situations. Medicare requires hospitals to follow special claim reporting rules if a device used in a procedure was provided at no cost or reduced cost. When a no-cost implant is reported correctly on the claim, the APC reimbursement would be reduced by 36.49%, around $2,080.00.

Our paper discussing those billing requirements is attached, but unfortunately, this guidance isn?t applicable to the situation in which no implant was used at all.

Effective 1/1/19, Medicare created HCPCS C1890 to report such cases in an Ambulatory Surgery Center, but has made it clear that this is not a code that is available to OPPS providers. https://www.cms.gov/Outreach-and-Education/ Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/MM11099.pdf

3

PARA Weekly eJournal: June 12, 2019

DEVICE-DEPENDENT CODE BILLING EDIT

4. New HCPCS Code C1890 For When No Device Is Used in ASCs for Device-Intensive Procedures Effective January 1, 2019 In the CY2019 OPPS/ASC Final Rule, CMS finalized its policy to apply the ASC device-intensive procedure payment methodology to device-intensive procedures under the ASC payment system, when the device intensive procedure is furnished with a surgically inserted or implanted device (including single use medical devices). Because devices are packaged into the procedure payment for device-intensive procedures, and ASCs do not report packaged codes, it is necessary to implement a mechanism to report when an ASC performs a device-intensive procedure without an implantable or inserted medical device. To implement this policy, CMS is establishing a new C-code that ASCs must report, specifically, HCPCS C1890, along with the device-intensive procedure code, to signify that the device was not furnished with the device-intensive procedure. This code is payable in the ASC setting only, and should not be reported on institutional claims by hospital outpatient department providers.

Therefore, HCPCS code C1890 is assigned to SI=E1 (Not paid by Medicare when submitted on outpatient claims (any outpatient bill type)) under the OPPS. Since this HCPCS code is not included on the current 2019 Alphanumeric HCPCS release, MACs will add this code to their system. The C1890 short descriptor is: No device w/dev- intensive px. The long descriptor is: No implantable/insertable device used with device-intensive procedures.

One of our California clients reached out to their Medicare Administrative Contractor with this problem on another code. They were verbally advised to report a nominal amount, i.e. $1.00, for an implant code on their claim in order to get it to pass edits. If you should obtain this same advice from your MAC, we recommend that the hospital document fully this instruction ? who from the MAC gave that instruction, and on what date, etc.

There is a possibility that by adding an implant charge at a nominal fee, such as $1.00, Medicare may pay the full APC amount. If Medicare eventually finds that the reduced APC rate should have been paid, the hospital should be prepared to explain why the claim listed an implant that was not provided, albeit at a nominal charge.

We have received at least two other examples of hospitals struggling with this problem, and we have reached out to CMS by email with an appeal for assistance.

We have not received a reply to our request for guidance. Therefore, we recommend asking your MAC for their guidance, and documenting carefully their reply in the account notes on the claim.

4

PARA Weekly eJournal: June 12, 2019

OR TIME-BASED CHARGE CALCULATIONS

Is there guidance available as to when the surgery times should start? We have received conflicting information as to whether it is when the patient enters the OR or if it is the incision start time or another time?

Answer: There is no regulation which governs the calculation of the time increment.

Typically, OR room time charges are based on the start/stop surgical time on the anesthesia record or ?wheels in to wheels out.?

Whichever approach the hospital takes, it should use the same method consistently. We have attached our paper on the perioperative charge process.

5

PARA Weekly eJournal: June 12, 2019

BILLING FOR OXYGEN

Do we have to have an order for oxygen to be able to charge for it? Initially we though yes, but we did have some feedback that when it is used for patient comfort we may not need an order but can still charge.

Can you clarify for us?

Answer: Yes, a physician order must be present to support the charge for oxygen. I have attached our paper on billing for oxygen and pulse oximetry.

6

PARA Weekly eJournal: June 12, 2019

PBB UROLOGY SERVICE AND REVENUE CODES

We are starting up a PBB Urology Service and have a question on what revenue codes are appropriate. If a clinic type procedure is performed outside of the actual PBB physical space by the PBB provider and PBB staff, should revenue 761 be used for the facility fee and 982 for the professional fee? If a like procedure was performed within the PBB physical space, we would use 510 and 983. Based on PBB guidelines, what revenue codes would be appropriate in either scenario?

Answer: If the acronym PBB stands for provider-based billing, then services performed in the PBB services will be within licensed hospital space.

However, we need a little more information in order to fully understand your question.

What location would be (as you described) ?outside of the actual PBB physical space? ? ? is that ?outside? area still within the licensed space of the hospital?

For professional fees on a Critical Access Hospital Method II claim (851 bill type), we usually recommend the generic revenue code 0960, since we sometimes hear about the less common pro fee revenue codes causing claim edits. However, 0982 or 0983 are also acceptable ? so long as they don?t complicate the billing process.

Here?s a list of all the professional fee revenue codes:

7

PARA Weekly eJournal: June 12, 2019

PBB UROLOGY SERVICE AND REVENUE CODES

As for the facility fee, many HCPCS are reportable under revenue code 0761 (treatment room), and there may be many acceptable revenue codes for any given HCPCS. The best practice is to use the revenue code which best matches the hospital department or area that will incur the cost (labor and equipment) in support of the procedure. Revenue should flow to the corresponding cost center.

The PARA Editor Calculator tab offers a list of potential revenue codes for each HCPCS ? here?s how to run that report: Enter the HCPCS in the field on the left, and select the ?HCPCS? report on the right; hit ?submit?:

8

PARA Weekly eJournal: June 12, 2019

PBB UROLOGY SERVICE AND REVENUE CODES

For professional fees on a Critical Access Hospital Method II claim (851 bill type), we usually recommend the generic revenue code 0960.

9

PARA Weekly eJournal: June 12, 2019

PBB UROLOGY SERVICE AND REVENUE CODES

Here?s the detail screen, with the revenue code ?accordion? for HCPCS 51700 expanded ? as you can see, there are a number of options:

10

PARA Weekly eJournal: June 12, 2019

MEDICATION ASSISTED TREATMENT FOR SUBSTANCE ABUSE

M

edicat ion assist ed t r eat m en t (M AT) is of f er ed t o pat ien t s w h o h ave a cu r r en t diagn osis of opioid u se disor der (OUD), m oder at e or sever e, an d w h o m eet pr e-det er m in ed cr it er ia f or par t icipat ion . Th e dr u g of ch oice f or t h is paper is bu pr en or ph in e/ n aloxon e, h ow ever , t h e sam e gu idelin es w ou ld apply acr oss all dr u gs u sed in t h e opioid depen den ce.

Pr ovider s sh ou ld n ot e; t h e except ion is m et h adon e, as t h is is n ot a Par t D dr u g w h en u sed f or t r eat m en t of opioid depen den ce becau se it can n ot be dispen sed f or t h is pu r pose u pon a pr escr ipt ion at a r et ail ph ar m acy.

Th e m edicat ion of ch oice is bu pr en or ph in e/ n aloxon e f or n on -pr egn an t par t icipan t s an d bu pr en or ph in e sin gle in gr edien t f or pr egn an t par t icipan t s. Pr e-au t h or izat ion by in su r an ce is r equ ir ed as som e payer s h ave specif ic br an d pr ef er en ces f or bu pr en or ph in e/ n aloxon e com bin at ion m edicat ion .

Nat ion al an d st at e gu idelin es su ggest M AT pr ogr am par t icipat ion be m an aged as elect ive t r eat m en t an d sh ou ld h ave a specif ic sign ed in f or m ed con sen t .

REPRINTED By Requ est

11

PARA Weekly eJournal: June 12, 2019

MEDICATION ASSISTED TREATMENT FOR SUBSTANCE ABUSE

There are two options for setting up a successful program that will assist the patient from - the first steps of induction phase, moving on to - stabilization phase and ending with - maintenance phase For each of these steps, the best practice would be to include a full treatment team that includes: - Front office nursing - Prescriber - Medical records/billing - Program administrator Option 1 approach suggestion: The nursing team complete most of the paperwork, screening and diagnostic forms, medication history, and withdrawal scales.

The prescriber meets with the patient for a face-to-face encounter to confirm diagnosis, treatment plan and write appropriate prescriptions.

Under this option, this will typically be a lower level of service code (99213-99214 (Induction phase)).

12

PARA Weekly eJournal: June 12, 2019

MEDICATION ASSISTED TREATMENT FOR SUBSTANCE ABUSE

Option 2 approach suggestion: The prescriber meets face-to-face with the program participant on the day of induction, completes the history and physical, administers the first buprenorphine dose, and then continues to monitor and observe the patient over a period extending 1-2 hours in a clinic setting.

This option will result in a higher level of service code (99215 plus extended care 99354). It is important to note, if using the higher level of care option, documentation by the prescriber must meet the criteria of the patient?s current treatment plan.

Recommended diagnosis for MAT claims is F11.20 = Opioid dependence.

The following are examples of structured visits for MAT. Pre-Induction visit: - Visit type: Adult Wellness Visit (AWV) or acute visit for Opioid Use Disorder/ Dependence - Comprehensive evaluation of new patient or established patient for suitability for buprenorphine treatment - New patient code 99205 - Established patient code 99215 13

PARA Weekly eJournal: June 12, 2019

MEDICATION ASSISTED TREATMENT FOR SUBSTANCE ABUSE

Induction Visit - Visit type: MAT medication induction - Any of the new patient evaluation and management (E/M) codes can be used for induction visits.

Codes are listed in order of increasing length of time with the patient and/or the severity level of the patient problems - Established patient codes 99212-99215 - Prolonged visits codes (99354 ? 99355) may also be reported as an add-on code to the assigned E/M code for services that extend beyond the typical service time, with or without face-to-face contact. Time spent does not need to be continuous - 30-74 minutes is typical for 99354 - 75-104 minutes is typical for 99355 - 105+ minutes would be typical for 99354 and 99355 X2 Maintenance Visit - Visit type: MAT medication. Acute visit for OUD/opioid dependence - Any of the established patient E/M codes can be used for maintenance visits - Counseling codes are more common in coding for maintenance visits, since counseling and coordination of service with addiction specialists comprise the majority of the follow-up visits.

- Established visit codes 99212-99215 Screening, Brief Intervention and Referral for Treatment (SBIRT) can be offered and is billable for naloxone education.

For commercial payer plans provider report 99408:

14

PARA Weekly eJournal: June 12, 2019

MEDICATION ASSISTED TREATMENT FOR SUBSTANCE ABUSE

Medicare providers can report G2011, G0396 or G0397:

Coding examples for participants of MAT programs with Behavioral Health Problems (BHPs) Counseling and coordination of services with MAT BHPs are going to fall within the maintenance visit phase of the program. Counseling codes should be used in place of E/M codes (99212-99215) when more than 50% of a visit is dedicated to counseling or coordination of care. Coding is then based on the total visit time, not just the time spent counseling or coordinating the care.

Assessment visits (MAT Intake): - Visit type: Diagnostic Evaluation - New or established patient: 90791

Induction Visits - Visit type: MAT BH - Mental Health Assessment by a Non-Physician: H0031 Maintenance Visits - Visit type: MAT BH - BH consult during MAT med visits - Mental Health Assessment by a Non-Physician: H0031 15

PARA Weekly eJournal: June 12, 2019

MEDICATION ASSISTED TREATMENT FOR SUBSTANCE ABUSE

- Psychotherapy: For use in all settings with patient or family (with no medical evaluations and management) - 30 (16-37) minutes: 90832 - 45 (38-52) minutes: 90834 - 60 (53+) minutes: 90837 Screening, Brief Intervention and Referral for Treatment (SBIRT) can be offered and is billable for naloxone education with MAT BHP participants (99408).

Billing considerations that should be reviewed and noted by providers: - Extent to which medication is covered by payer - Medicaid covers office-based buprenorphine treatment. Prior authorization is required - Medicare may not cover office-based buprenorphine induction and maintenance visits - Medicare Part D may cover the cost of the buprenorphine tablets - Prior authorization is require--however, only some Medicare providers will reimburse - Almost all major insurances cover the cost of the prescription. Some private health insurers have standard billing codes for buprenorphine treatment services - For example, Cigna requires that clinicians use H0033 for buprenorphine related visits

- Patients who do not have coverage or are uninsured can apply for a patient assistance program (PAP) for buprenorphine through the pharmaceutical company - Some program participants may qualify for free medications for up to one year References: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra /Downloads/Part-D-Benefits-Manual-Chapter-6.pdf

16

PARA Weekly eJournal: June 12, 2019

MEDICATION ASSISTED TREATMENT FOR SUBSTANCE ABUSE

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/SE18004.pdf

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles /Downloads/SE18016.pdf

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/MM11063.pdf

17

PARA Weekly eJournal: June 12, 2019

HETS QUERY FOR MEDICARE DIABETES PREVENTION PROGRAM

has announced changes to the HIPAA Eligibility Transaction System (HETS) that will allow query returns for Medicare Diabetes Prevention Program (MDPP) usage information.

The HETS Medicare beneficiary eligibility response (Form 271) includes HCPCS codes for MDPP services if the National Provider Identifier (NPI) on the eligibility inquiry (270) belongs to a Medicare enrolled MDPP supplier or if it includes the Service Type Code ?CQ? https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/ HETSHelp/Downloads/R2018Q200HETS270271ReleaseSummary.pdf

CM S

Providers will be able to use this information to determine the next available MDPP service for Medicare beneficiaries.

If the Medicare beneficiary is ineligible for MDPP, HETS will not return MDPP usage information.

The 271-return query should display the following HCPCS codes: - No prior MDPP usage: G9873 - MDPP usage: G9873, G9874, G9875, G9876, G9877, G9878, G9879, G9880, G9881, G9882, G9883, G9884, G9885, G9890, and G9891, including the reporting NPI and the date of service - G9890 and G9891 can be returned multiple times. All other MDPP HCPCS codes are once-in-a-lifetime services and will only return once

18

PARA Weekly eJournal: June 12, 2019

HETS QUERY FOR MEDICARE DIABETES PREVENTION PROGRAM

Providers should note: - MDPP eligibility data does not impact non-MDPP services - Providers must be enrolled as an MDPP supplier to be able to provide MDPP services to Medicare beneficiaries and to be able to bill Medicare for these services - Not an enrolled MDPP supplier? https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/ MedicareProviderSupEnroll/EnrollmentApplications.html

https://www.cms.gov/Outreach-and-Education/Outreach/NPC/National-Provider-Callsand-Events-Items/2017-12-05-Diabetes.html

19

PARA Weekly eJournal: June 12, 2019

BILLING REQUIREMENTS FOR CHIROPRACTIC CARE

In 2018, the Comprehensive Error Testing Program (CERT) that measures improper payments in the Medicare Fee-For-Service (FFS) program reported a 41 percent error rate on claims for chiropractic services. Most of those errors were due to insufficient documentation or other documentation errors.

Medicare limits coverage of chiropractic services to treatment by means of manual manipulation (that is, by use of the hands) of the spine to correct a subluxation. The patient must require treatment by means of manual manipulation of the spine to correct a subluxation, and the manipulative services the doctor of chiropractic provides must have a direct therapeutic relationship to the patient?s condition and provide reasonable expectation of recovery or improvement of function.

The doctor of chiropractic may use manual devices (that is, those that are hand-held with the thrust of the force of the device being controlled manually) in performing manual manipulation of the spine. However, Medicare makes no additional payment for use of the device, nor does Medicare recognize an extra charge for the device itself.

Doctors of chiropractic are limited to billing three CPTÂŽ codes under Medicare: For detailed information, - 98940 (chiropractic manipulative treatment; spinal, one to two regions), - 98941 (three to four regions), and click here.

- 98942 (five regions) When submitting manipulation claims, doctors of chiropractic must use an Acute Treatment (AT) modifier to identify services that are active/corrective treatment of an acute or chronic subluxation. The AT modifier, when used appropriately, should indicate expectation of functional improvement, regardless of the chronic nature or redundancy of the problem.

Documentation Requirements: The Social Security Act states that ?no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.?

20

PARA Weekly eJournal: June 12, 2019

HOSPICE PROVIDERS PREVIEW REPORTS AVAILABLE JULY 1, 2019

Two reports are available in your Certification and Survey Provider Enhanced Reports (CASPER) non-validation reports folder: - Hospice provider preview report: Review Hospice Item Set (HIS) quality measure results from the fourth quarter of 2017 to the third quarter of 2018 - Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPSÂŽ) provider preview report: Review facility-level CAHPS survey results from the fourth quarter of 2016 to the third quarter of 2018 Review your HIS and CAHPS results by July 1, 2019. If you believe the denominator or other HIS quality metric is inaccurate or if there are errors in the results from the CAHPS survey data, request a CMS review: For detailed information, click the documents below.

21

PARA Weekly eJournal: June 12, 2019

RURAL HOSPITAL PROGRAM GRANTS AVAILABLE

Rural hospitals and clinics face their own set of unique and burdensome challenges when it comes to program development, cash management and maintaining volume. That's why it's great when they can get some assistance from external funding sources.

At PARA, we've found an excellent source of funding opportunities for rural healthcare facilities.

Here are some examples.

340B Drug Pricing Program - The program provides prescription drugs at a reduced cost to eligible entities. Participation in the Program results in significant savings estimated to be 20% to 50% on the cost of pharmaceuticals for safety-net providers.

- Registration periods are open 4 times throughout the year, and are processed in quarterly cycles.

- Funding cycles are as follows: July 1 - July 15 for an October 1 start date; October 1 - October 15 for a January 1 start date

Tribal Opioid Response Grants Provides up to $50,000 to develop a strategic plan to address opioid addiction in tribal nations.

Application Deadline: August 6, 2019

Small Ambulatory Program For Native Americans And Alaska Natives Provides up to $2,000,000 to fund ambulatory healthcare facilities on municipal, private or Tribal land to provide healthcare services to eligible Native Americans. Can be used for modernization or expansion of existing facilities, or new or replacement facilities.

Application Deadline: June 28, 2019

22

PARA Weekly eJournal: June 12, 2019

MLN CONNECTS PARA invites you to check out the mlnconnects page available from the Centers For Medicare and Medicaid (CMS). It's chock full of news and information, training opportunities, events and more! Each week PARA will bring you the latest news and links to available resources. Click each link for the PDF!

Thursday,June 6, 2019 New s

· Medicare Shared Savings Program: Submit Notice of Intent to Apply Beginning June 11 · Promoting Interoperability Program: Submit Comments on Proposed Changes by June 24 · Promoting Interoperability Program: Submit a Measure Proposal by June 28 · Hospice Provider Preview Reports: Review Your Data by July 1 · PEPPERs for Short-term Acute Care Hospitals Com plian ce

· Bill Correctly for Device Replacement Procedures Claim s, Pr icer s & Codes

· ICD-10-PCS Procedure Codes: FY 2020 · Average Sales Price Files: July 2019 Even t s

· DMEPOS Competitive Bidding: Round 2021 Webcast Series · Developing a Hospice Assessment Tool Special Open Door Forum ? June 12 · Ligature Risk in Hospitals Listening Session ? June 20 · Hospital Co-location Listening Session ? June 27 M LN M at t er s® Ar t icles

· Chimeric Antigen Receptor (CAR) T-Cell Therapy Revenue Code and HCPCS Setup Revisions · Documentation of Medical Necessity of the Home Visit; and Physician Management Associated with Superficial Radiation Treatment

23

PARA Weekly eJournal: June 12, 2019

WEEKLY IT UPDATE

PARA HealthCare Analytics has provided a list of enhancements and updates that our Information Technology (IT) team has made to the PARA Data Editor this past week.

The following tables includes which version of the PDE was updated, the location within the PDE, and a description of the enhancement.

Week ly IT Updat e

Prev ious Updates

24

PARA Weekly eJournal: June 12, 2019

There was ONE new or revised Med Learn (MLN Matters) article released this week.

To go to the full Med Learn document simply click on the screen shot or the link.

FIND ALL THESE MED LEARNS IN THE ADVISOR TAB OF THE PDE

25

1

PARA Weekly eJournal: June 12, 2019

The link to this Med Learn MM11321

26

PARA Weekly eJournal: June 12, 2019

There were 2 new or revised Transmittals released this week.

To go to the full Transmittal document simply click on the screen shot or the link.

FIND ALL THESE TRANSMITTALS IN THE ADVISOR TAB OF THE PDE

27

2

PARA Weekly eJournal: June 12, 2019

The link to this Transmittal R2313OTN

28

PARA Weekly eJournal: June 12, 2019

The link to this Transmittal R4317CP

29

PARA Weekly eJournal: June 12, 2019

Con t act Ou r Team

Peter Ripper

M onica Lelevich

Randi Brantner

President

Director Audit Services

Director Financial Analytics

m lelevich@para-hcfs.com

rbrantner@para-hcfs.com

pripper@para-hcfs.com

Violet Archuleta-Chiu Senior Account Executive

Sandra LaPlace

Steve M aldonado

Account Executive

Director Marketing

slaplace@para-hcfs.com

smaldonado@para-hcfs.com

varchuleta@para-hcfs.com

Nikki Graves

Sonya Sestili

Deann M ay

Senior Revenue Cycle Consultant

Chargemaster Client Manager

Claim Review Specialist

ngraves@para-hcfs.com

ssestili@para-hcfs.com

dmay@para-hcfs.com

M ary M cDonnell

Patti Lew is

Director, PDE Training & Development

Director Business Operations

mmcdonnell@para-hcfs.com

plewis@para-hcfs.com

30

PARA Weekly eJournal: June 12, 2019

31