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Today's Arctic is characterized by a lengthening of the sea ice melt season, but also by fast and at times unseasonal melt events. Such anomalous melt cases have been identified in Pacific and Atlantic Arctic sector sea ice studies. Through observational analyses, we document an unprecedented, simultaneous marginal ice zone melt event in the Bering Sea and Labrador Sea in March of 2023. Taken independently, variability in the cold season ice edge at synoptic time scales is common. However, such anomalous, short-term ice loss over either region during the climatological sea ice maxima is uncommon, and the tandem ice loss that occurred qualifies this as a rare event. The atmospheric setting that supported the unseasonal melt events was preceded by a sudden stratospheric warming event that, along with ongoing La Niña teleconnections, led to positive tropospheric height anomalies across much of the Arctic and the development of anomalous mid-troposphere ridges over the ice loss regions. These large-scale anticyclonic centers funneled extremely warm and moist airstreams onto the ice causing melt. Further analysis identified the presence of atmospheric rivers within these warm airstreams whose characteristics likely contributed to this bi-regional ice melt event. Whether such a confluence of anomalous wintertime events associated with troposphere-stratosphere coupling may occur more often in a warming Arctic remains a research area ripe for further exploration. [ABSTRACT FROM AUTHOR]

Every year family physicians and their staffs are given the challenge of managing changes in coding and Medicare payment policy. While some years it may be easy to tell whether the changes as a whole benefit your practice financially, this year it's complicated. Some policies will cut payments and others should boost revenue for family physicians. Despite annual threats to Medicare's physician payment rate, primary care physicians will benefit from the implementation of a new code for visit complexity, among other key changes. [ABSTRACT FROM AUTHOR]

There are a host of changes that will affect family physicians, including new vaccine codes and bundled Medicare payments for chronic pain management. [ABSTRACT FROM AUTHOR]

The 2022 updates don't include massive E/M coding changes like last year, but several changes are much-needed and relevant to family physicians. [ABSTRACT FROM AUTHOR]

Progress has been made on several fronts, including prior authorization reform and reducing documentation burdens. But there's more work to do. [ABSTRACT FROM AUTHOR]

This year's changes bode well for family physicians, with an expected increase in Medicare allowed charges. [ABSTRACT FROM AUTHOR]

Simplified guidelines for coding and documenting evaluation and management office visits are coming next year. Learn how to apply the guidelines to some common visit types. [ABSTRACT FROM AUTHOR]

The Centers for Medicare & Medicaid Services is trying to make Medicare documentation less burdensome and planning more changes that should result in a pay raise for family physicians in the future. [ABSTRACT FROM AUTHOR]

This year's changes include some welcome documentation relief, new codes for portal and telephone encounters, and much more. [ABSTRACT FROM AUTHOR]

New codes for cognitive assessment and care planning, team-based care management, prolonged preventive services, and anticoagulation management are among this year's changes. [ABSTRACT FROM AUTHOR]

The article discusses the opportunities and changes brought about by revised codes and billing rules that may affect family physicians in the U.S. Topics covered include the simplification of Medicare's billing requirements following changes to the scope of service elements for chronic care management (CCM), the average payment amount set by the Centers for Medicare and Medicaid Services (CMS) and the approval of a code for patients with cognitive impairment.

The article presents questions and answers related to chronic care management billing under the Centers for Medicare and Medicaid Services including the definition of a calendar month, the place of service code to be used and the documentation of the practice including electronic health record.

The article offers information on tools for billing chronic care management (CCM) services in physician practice. Topics covered include Centers for Medicare and Medicaid Services (CMS) payment for CCM services starting January 1, 2015, access of patients to CCM services 24 hours a day, management of care for chronic conditions and home-care coordination. Also mentioned are other Current Procedural Terminology (CPT) code changes including vaccines, fluoride application and joint injections. INSET: OTHER CPT CHANGES OF NOTE.

The article reports on decision making practiced by physicians relative to the Documentation Guidelines for Evaluation and Management (E/M) under the Medicare of the U.S. It states that guidelines focus on the review of diagnosis, management options and the medical data. It asserts that physicians must consider the risk encountered by the patient in deciding for the treatment. However, it says that the guidelines do not offer adequate information regarding the appropriate number of diagnosis.

The article offers information on the 1997 version of Medicare's Documentation Guidelines for Evaluation and Management Services in the U.S. It states that the 1997 version is an option rather than a substitution for the 1995 version. It cites the 1997 version of Medicare's evaluation and management documentation guidelines which expand the multisystem exam definition which includes 11 single-system exams.