Indira Kanouka, MD
Indira Kanouka, MD, has joined Capstone Performance Systems’ consulting team. A private practice physician in New Jersey, Dr. Kanouka had previously served as medical director of Beacon of Life, a PACE (Program of All-inclusive Care for the Elderly) organization, and of Specialty Hospital of Central Jersey.
Dr. Kanouka has extensive experience working with the geriatric population, including directing…
Kim Browning, CHC, PMP, has joined Tabula Rasa HealthCare (TRHC) as Executive Vice President (EVP) responsible for subsidiary company Capstone Performance Systems and its new division, Peak Health Plan Management, which resulted from Capstone’s recent acquisition of Peak PACE Solutions, an Altitude Edge company.
Kim Browning
Most recently, Ms. Browning was EVP of Cognisight, LLC, in Rochester, New…
After more than 30 years in the field of geriatric care, including more than 15 years focusing on PACE (Programs for All-inclusive Care for the Elderly), Capstone Performance Systems founding CEO Richard Schamp, MD, has announced he is turning over the reigns of the company to colleague Kim Browning. After a short break, Dr. Schamp will provide broader leadership support through Tabula Rasa HealthCare (TRHC), Capstone’s parent company.
In the past year, Capstone’s leadership team has taken steps to prepare for…
On May 1, Tabula Rasa HealthCare (TRHC), parent company of Capstone Performance Systems, acquired Peak PACE Solutions from Altitude Edge (AE), following the news of AE founders’ David Reyes and Ronda Hackbart retirements. Peak PACE Solutions is now Peak Health Plan Management Services and will operate as a service of Capstone.
“Capstone’s mission is to help our client organizations succeed fiscally in a compliant manner,” said Capstone CEO Richard Schamp, MD. “Having worked collaboratively for years with Peak, we look…
By Matt Zimmerman
Director of Client Success/Part D Consultant
It’s that time of year again! We have been advised that CMS is in the process of notifying PACE plans of their selection for the next round of 1/3 Part D Financial Audits. Selected plans will receive a notice from the CPA contracted to conduct this year’s audits shortly. If your plan is selected for this round of Part D financial audits, the audit team will be focusing on Payment Year 2017….
By Denise Wills, CPC-A
When documenting depression, accuracy is important in determining the most specific code. If incomplete documentation is received, it will result in an unspecified code selection, which does not map to an HCC. For example, ICD-10 code F32.9 (MDD, single episode, unspecified) does not map to an HCC, whereas F32.0 (MDD, single episode, mild) does.
The ICD-10 classification of Mental and Behavioral Disorders, developed in part by the American Psychiatric Association, classifies depression by code. Documentation of Major…
By Richard Schamp, MD
CEO
Richard Schamp, MD, CEO
In our last edition, I mentioned the burgeoning new competency for physicians and other clinical providers – clinical documentation excellence. Let’s delve further into some specifics around the kinds of competence required in a risk-adjusted payment model. CMS has a process to verify that diagnosis codes reported that are relevant for payments in the HCC (Hierarchical Condition Category) model…
By George “Mike” Brett, MD
Senior Vice President of Consulting and Chief Medical Officer
George “Mike” Brett, MD
Senior Vice President of Consulting and Chief Medical Officer
In addition to demographic information and HCCs, a portion of a PACE participant’s risk score is derived from the Frailty Factor (FF). Eligible participants in PACE have the FF added to their risk score because the CMS-HCC Model…
George “Mike” Brett, MD
Senior Vice President of Consulting and Chief Medical Officer
St. Louis, MO, and Moorestown, NJ, (April 4, 2018) – Capstone Performance Systems, a subsidiary of Tabula Rasa HealthCare, Inc. (“TRHC”) (NASDAQ:TRHC), today announced that George “Mike” Brett, MD, has been named Senior Vice President of Consulting. Dr. Brett, who retains his title of Chief Medical Officer for Capstone, will…
By Amanda Piern, CRC
Risk Adjustment Coder
ICD-10-CM significantly expanded the codes available for substance use disorders (SUDs). To properly code for these disorders, the diagnosis documentation should include the type of use disorder.
The ICD-10 index includes the following use disorders:
• Alcohol use
• Amphetamine-type substance use
• Cannabis use
• Cocaine use
• Hallucinogen use
• Inhalant use
• Opioid use
• Phencyclidine use
• Sedative
• Hypnotic
• Anxiolytic use
• Stimulant use (other) (unknown)
• Substance use (other) (unknown)
In each case, the provider must document the severity of…