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2 / 21 / 2023

CMS Changes ACO Application Cycle! Are You Ready?

By Kelly Conroy, Zach Maher & Daniela Yusufbekova
The Centers for Medicare and Medicaid Services finalized changes to the 2023 ACO application cycle steps and timelines. After collectively submitting 50+ successful applications, Pinnacle is excited to continue...
2 / 16 / 2023

New ACO/VBC Changes Announced: What You Need to Know!

By Kelly Conroy, Zach Maher & Daniela Yusufbekova
Our healthcare industry is undergoing a major transformation, with a focus on shifting from a fee-for-service model to a value-based model that prioritizes quality and outcomes over volume and cost....
1 / 26 / 2023

Sepsis Coding: How to Properly Code Sepsis

Introduction: Sepsis is a potentially life-threatening complication of an infection and occurs when chemicals released in the bloodstream to fight the infection trigger inflammatory responses throughout the body. This inflammation...
1 / 16 / 2023

Clinical Documentation Improvement: Are EMR Shortcuts Wreaking Havoc on Your Practice’s Documentation?

As providers look for ways to document more efficiently, they are increasingly turning to technology-based shortcuts. Unfortunately, there are some pitfalls associated with relying on some electronic medical record (EMR)...
11 / 11 / 2022

Diagnosis Coding: When to Assign a Diagnosis for E/M Services

With the implementation of the AMA (American Medical Association) E/M (Evaluation and Management) documentation guidelines for office and outpatient visits in 2021 (and the pending 2023 E/M guideline changes for...
10 / 21 / 2022

Summary Of CMS Proposed Rule Changes For 2023

By Anthony Long, Jason Baldwin, Lori Carlin & Robin Peterson
(Based on the July 7, 2022 Proposed Rule) Rate and Conversion Factors With the budget neutrality adjustments and the required statutory update to the conversion factor for CY 2023 of...
9 / 21 / 2022

Smart Pricing of Lumbar Stand-Alone Devices

By John Ossowski, Andrew Arreola & Kim Nilsson
Today’s vendor technology is no longer siloed into a specific classification. For example, an ALIF (anterior lumbar interbody fusion) device used to be just an ALIF.  Today, that same ALIF...
9 / 21 / 2022

Smart Pricing of Cervical Stand-Alone Devices

By John Ossowski, Andrew Arreola & Kim Nilsson
Today’s vendors now offer specific implant technology that can no longer be categorized into a single specific implant classification. For example, a cervical spacer used to be just a cervical...
9 / 8 / 2022

CMS Releases PY 2021 Financial and Quality MSSP Numbers

By Daniela Yusufbekova & Kelly Conroy
On Tuesday, August 30th, officials at the Centers for Medicare & Medicaid Services (CMS) released the latest financial and quality results for the Medicare Shared Savings Program (MSSP) performance year...
8 / 30 / 2022

Using Implant Data to Facilitate Surgeon Engagement

By John Ossowski, Andrew Arreola & Kim Nilsson
Engaging surgeons to assist in contracting for their implants has long been a challenge for most hospitals. Historical feedback from surgeons ranges from “it’s not my problem” to “I’ll just...