Aetna Update August 2022

Effective 11/1/2022 

Computer-assisted surgical and musculoskeletal navigation coding update.
Aetna® will no longer consider the following codes for separate reimbursement:
• 20985 (Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (List separately in addition to code for primary procedure))
• 0054T (Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure)). The use of computer-assisted surgical navigation is considered
integral to the performance of the procedure.

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Angelina County New Card

We apologize these are not the best pictures, but we wanted to get this out to you, asap.

Some of you have already seen this new card from Angelina County. POET’s contract is with Angelina County not GPA or Imagine 360. POET has reached out to both Angelina County and Imagine 360. Imagine 360 told POET the benefits have not changed. We have asked if your representative will remain the same and are waiting for that response. As information comes in, we will keep you informed. Please let POET know if you are not paid according to contract

Angelina County Self Funded Employer Group

What is the Value of Benefits for Staff

Do you know the actual value of benefits offered to your staff?

Maybe you should.

Maybe your staff should.

If you have been looking for a way to calculate the value of benefits offered for your staff, here is an option found on the MGMA Community.

Just click the download button to view the spreadsheet. 

The “how to” instructions are below.

It’s basic, but the employees seem to really like it.

1. Use the + to add a tab for each employee.
2. Rename each tab to your employee’s names.
3. Copy and paste the content from the ‘Employee A’ tab to the rest of your employee tabs.
4. Update the DATA INPUT tab with the amount your clinic pays for each employee on a monthly bases (this info will pull into the employee’s individual tabs).
5. In each employee tab, input the amount you pay monthly for Life Insurance (if you provide that benefit) in column B.
6. In each employee tab, modify as needed, the number of days you give for PTO, Holiday & the Retirement % (you’ll need to update both the description and also the formulas in column C).
7. Add or remove benefits as it applies to your clinic and employee. 


I hope you find this to be helpful!
Connie McVein, Chief Executive Officer
Oregon Neurology, Springfield OR

It Has to End Sometime. Doesn’t It?

What Will the End of the PHE Mean for Coverage?

The PHE has been extended 8 times since January 31st. We all have I fingers crossed that this is the last time. But there is a lot of uneasiness regarding the “WHAT IFs” of when it does. 

To get some great insight check out this article from TMA.ED

PHE Extended

July 15th, Secretary of Health and Human Services, Xavier Becerra renewed the determination that a public health emergency exists. This will add another 90 days, extending the PHE through October 13, 2022

PHE Extended

POET has been asked:

Where is the best place to order Approved 1500 Forms (Better known as HCFA of HICF)?

Please leave a comment below. Thank you.

Updates for Your Front Desk

Do you have the latest information at your finger tips?

Just for you!

No Surprise Act:

Share information with your patients to help protect them from surprise billing. 

As of January 1, 2022, they have new billing protections under the “No Surprise Act” when they receive:

  • Emergency care
  • Non-emergency care from out-of-network providers at in-network facilities
  • Air ambulance services from out-of-network providers

Just click the links below for printable information.

In all actuality this is info we all need to know - no surprises

UHC Policy and Protocol Updates

UHC Policy and Protocol Updates

AMA unveils anticipated E/M changes for facility-based services

The AMA set off its own fireworks during the Independence Day weekend with the early release of new E/M guidelines that will be included in the 2023 CPT manual and take effect Jan. 1, 2023

Beginning on that date, the format for office and other outpatient visits (99202-99215) will apply to hospital inpatient and observation visits, consults, and services in the emergency department, nursing facility, home and residence. As a result, history and physical examination will no longer contribute to the level for these visits. Instead, for most visits practices will select codes based on medical decision-making (MDM) or time. The only exception will be emergency department visits, which will be MDM-only because the codes do not have a time component.
 
Among the most radical changes, the AMA plans to delete all observation care codes (99217-99220, 99224-99226) and merge observation services with initial and subsequent hospital care codes (99221-99223, 99231-99233, and 99238-99239)