Renee Pearl MSN-Informatics OCN

Please help the Association of Healthcare Value Analysis Professionals (AHVAP) in welcoming the newest member, Robin Lundrigan, MS, RN, CVAHP to the Association of Healthcare Value Analysis Professionals (AHVAP) family. Welcome Robin! To learn more about Association of Healthcare Value Analysis Professionals (AHVAP) membership, visit: www.ahvap.org. #AHVAP #membershipmatters #valueanalysis #valuebasedcare

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How to Use Modifier 25 Questions about modifier 25 have increased since add-on code G2211 was implemented in 2024 to reflect the value primary care physicians provide to patients. Learn how to report modifier 25 correctly so that you can get paid accurately. What is modifier 25? Modifier 25 is a way to identify a “significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service,” according to the CPT 2024 code set. Modifier 25 may only be appended to evaluation and management services. When can it be used? The E/M service must be significant and distinct from the procedure. The E/M must reflect work that is above and beyond the usual work associated with the procedure or other service. Asking the following questions can help determine whether it is appropriate to use modifier 25: ✔️ Did you perform and document the key components of a problem-oriented E/M service for the complaint or problem? ✔️ As documented, could the E/M service stand alone as a billable service? ✔️ Is there a different diagnosis for this portion of the visit? ✔️ If the diagnosis will be the same, did you perform extra physician work that went above and beyond the work of the other service or the typical pre- or postoperative work associated with the procedure? Modifier 25 should not be used when: ❌ The sole purpose of the encounter is for the procedure (e.g., lesion removal), and there is no documented medical necessity for a separate E/M service. The decision to perform a minor procedure is included in the payment for the procedure and should not be reported as a separate E/M service. Example: Visit for lesion removal A patient presents to have a mole assessed and the physician decides to remove it. The decision to remove the mole is included in the procedure code and should not be billed as a separate E/M service. However, in this same scenario, if the mole has a suspicious, potentially malignant appearance that the physician relates to the patient, in a separate identifiable E/M service, and discusses the possible need for a more extensive procedure if the pathology report comes back positive for malignancy, the E/M visit would be reported with a 25 modifier, along with the procedure code for the lesion removal. https://lnkd.in/dgr3MHNT #medicalcoding #modifiers #modifier25 #enm #stayconnected #stayupdated

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How to improve healthcare by marrying value analysis with clinical outcomes to elevate patient care. Dr. Hudson Garrett, FACHDM, FAHVAP, FACHE, FSHEA, FNAP, FIDSA, Karen Niven and Anne Marie Orlando explore this intersection in there insightful upcoming article coming next week! #HealthDataManagement #ValueAnalysis #ClinicalOutcomes #EvidenceBased #HealthcareExcellence. 

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The Association of Healthcare Value Analysis Professionals (AHVAP) appreciates our ongoing collaboration with Health Data Management and Mitchell Josephson, FACHDM as we advance safety across the healthcare continuum. Check out our next article highlighting the utilization of evidence-based medicine in the evaluation of new products and technologies as part of the clinical value analysis process. #AHVAP #HDM #valueanalysis #clinicaloutcomes #valuebasedcare #EBM #EBP #evidencebasedcare

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Check out this article by GWEP experts Dr. Brian Isetts and Dr. Kris Talley: 💊 Development and Evaluation of a Reliable Medication Management Self-Assessment Checklist is now published in Innovations in Pharmacy Practice https://bit.ly/4bJJZ9W #MedicationManagement

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How will Osteoporosis provider certification improve access, quality, and quantity of care?   Will certification training and testing in osteoporosis care impact my practice? Certification provides a baseline of knowledge in a field and leverages requirements for continuing education to maintain and expand knowledge throughout one’s career. It plays a crucial role in developing standards of care and provides an inventory of practitioners in a specialty, all of which can significantly enhance your practice. Over 1.5 million healthcare providers and five million allied health providers have obtained certification, which has become the standard in US healthcare. While over 1,000 providers have obtained certification in densitometry in the USA, there is no other certification for healthcare providers in the osteoporosis disease state. This glaring gap in certification is a pressing issue, demanding that healthcare providers step up and fill the void. Does anybody notice the void? 1:2 women and 1:4 men over age fifty are projected to suffer an osteoporosis-related fracture in their lifetime. That equates to nearly 40% of all Americans over age 50! Fracture rates are on the rise, and osteoporosis treatment is falling. To reduce fracture risk, we must do something other than maintain the status quo. Train the healthcare team, identify synergies within the medical system that will positively impact osteoporosis risk, and create standards of care for osteoporosis treatment.  What does synergy look like? It could be as simple as adding bone health evaluation with your patient visit who has comorbid conditions (DM, Lung Disease, GI disease, etc.). It could be focusing attention and resources on orthopedic preoperative risk assessment of bone health. Those resources could reduce direct complications from the 800,000+ total knee arthroplasties, 550,000+ hip arthroplasties, and 500,000+ spinal fusions and reduce fracture risk. By looking for post-fracture patients, aggressive identification and treatment could reduce the refracture rate significantly. By reducing 1% of surgical complications resulting from poor bone stock, hundreds of millions of dollars could be saved.  Reduce the overall fracture rate by a conservative 10%, the savings from fracture care alone would exceed $1 billion. Reduce the refracture rate, another $1 billion in savings. This is not just a financial benefit but also a testament to the improved quality of life for those who would have otherwise suffered from osteoporosis-related fractures. Looking at the larger picture, we cannot mount a successful response to the national epidemic of osteoporosis without certification-level training and testing. 

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How would this have impacted your practice in the beginning? How would this impact onboarding new staff or a new service line?

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Just released! Our #SDOH and #HealthEquity Workgroup has published "Recommendations for Determinant Capture," suggested guidelines for standardizing how domain risk is captured in #EHRs. "Absence of clear guidelines for risk assessment and standardized representation of risks in EHRs hinders effective data exchange to inform interactions at the point of care," writes the Workgroup. Click here to download: https://ow.ly/WTaj50RpvuC

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NEWS 📰 Implementing Adult Hepatitis B Immunization and Screening Using Electronic Health Records: A Practical Guide - [Vaccines] 🔊 This guide is intended to help clinical champions, EHR review committees, laboratory medicine, and information technology professionals develop medical support strategies that are easy to follow and target the appropriate patients. As health systems work towards the implementation of the new CDC recommendations, it will be important to document and share key learnings and strategies on the technical implementation of EHR schematics, the adapting of EHR tools for key subgroups, and the barriers to implementation. 🗞️ https://lnkd.in/eFFStYy8 📚🪶Featuring authors: Michaela Jackson, MS and Chari Cohen, DrPH of the Hepatitis B Foundation.

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#AHRQ will publish a NOFO to create State-based Healthcare Extension Cooperatives to accelerate patient-centered outcome #research (PCOR) implementation. Learn more about this Notice of Intent. https://lnkd.in/e8NPrP8d

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#AHRQ will publish a NOFO to create State-based Healthcare Extension Cooperatives to accelerate patient-centered outcome #research (PCOR) implementation. Learn more about this Notice of Intent. https://lnkd.in/e8NPrP8d

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#AHRQ will publish a NOFO to create State-based Healthcare Extension Cooperatives to accelerate patient-centered outcome #research (PCOR) implementation. Learn more about this Notice of Intent. https://lnkd.in/e8NPrP8d

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#AHRQ will publish a NOFO to create State-based Healthcare Extension Cooperatives to accelerate patient-centered outcome #research (PCOR) implementation. Learn more about this Notice of Intent. https://lnkd.in/e8NPrP8d

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Be there this September 20-22 for CSRO's flagship Advocacy Conference!   Our curated program will feature sessions highlighting current issues impacting patients and practices like copay assistance, 340B, the Inflation Reduction Act, and more - don't miss out. Visit our website to learn more and register: https://lnkd.in/gmcJeQgv #Advocacy #AdvocacyConference #Rheumatology #Rheumatologists #Networking

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Reminder! The classic ClinicalTrials.gov website is being retired tomorrow and will no longer be available. View the recording from our recent webinar to learn more about the transition: https://lnkd.in/et3mjA_p

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Clinical impact of medication review and deprescribing in older inpatients: A systematic review and meta-analysis. #geriatrics https://lnkd.in/gzzN5Hgf

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