Question 1: Are you aware of the new requirements to avoid a MIPS penalty for the 2018 reporting period?
Answer: The threshold to avoid a penalty for the 2018 reporting period is 15 MIPS points. This can be accomplished by achieving a perfect score in the Clinical Practice Improvement Activities category.
Question 2: A patient undergoes an open amputation and returns to the operating room two days later for a staged debridement and closure. Which CPT modifier is most appropriate for the second procedure?
Answer: The correct answer is "1. 58 modifier." The 58 modifier would be most appropriate based on the staged, planned nature of the second procedure.
Question 3: Do you know how to determine whether you are exempt from MIPS in 2018? Hint: You may be exempt, even if you were not in 2017.
Answer: For the 2018 reporting period, you are exempt from MIPS if you had less than $90,000 in Medicare Part B allowable or fewer than 200 Medicare Part B beneficiaries between September 1, 2016, and August 31, 2017.
Learn all about MIPS and the documentation necessary to support the use of the 58 modifier in the above scenario as well as discussion of all the modifiers we use at the upcoming APMA MIPS and Coding Seminar.
Contact APMA's Health Policy and Practice Department.
Health Policy and Practice
APMA Health Policy and Practice Department