Part B News | Part B News

Get review of systems right to get level 3 and level 4 E/M codes paid

09/19/2011

You and your peers bill level 3 and level 4 E/Ms to Medicare more than any other service, but confusion over whether which of these levels is right causes many physicians to defer to a 3, which won’t reduce audit risks but will reduce revenue, experts say. Use these three strategies to improve physician documentation so you keep more of the revenue earned from the two most common E/M services.

The fine print behind recording patient vitals, demographics and smoking status

09/19/2011

by: Grant Huang

You won’t have a hard time recording patients’ vitals, demographics and smoking status, but you may not have to in some cases. The key is to incorporate the collection of these data points seamlessly into your workflow, experts say. While practices that have met meaningful use say these measures were easier to achieve than other core measures, you must be aware of these less well-known facts about them.

Two major CMS clarifications on subsequent observation codes

09/19/2011

by: Laura Evans

You can’t add prolonged services on top of the new subsequent observation codes (99224-99226), and you now have explicit rules from CMS on whether the admitting or consulting physician should bill subsequent observation. CMS has clearly taken a position against CPT, which means you may have to code differently for Medicare patients and privately insured patients who get the same services in the same situation.

You could be recruited to partner in bundled payments initiative

09/19/2011

by: Lauren C. Williams

Your practice could be approached by your local hospital to enroll in CMS’s new bundled payment pilot program. You may also be recruited by a “convener” – an organized group of practices who want to participate, experts tell Part B News. The bundled payments initiative is essentially a step down from an accountable care organization (ACO) but more flexible, says Neil Kirschner, senior associate of regulatory affairs for the American College of Physicians (ACP).

5010 transaction standard will require physical billing address

09/19/2011

by: Marla Durben Hirsch

When you submit claims electronically, check to see if you’re using a post office box or lock box on your claim forms. If you are, you need to change the information in your billing provider address field in order to comply with HIPAA and get paid on time. Version 5010 requires you to use a physical street address in the billing provider address field, not a P.O. or lock box.

Benchmark of the Week: Medicare contractor performance, 2011

09/19/2011

by: Grant Huang

How much do you like your Medicare carrier or administrative contractor? These charts show averages of carrier and MAC satisfaction scores from your peers across the country. The overall satisfaction scores are higher than the average of the scores of specific business functions. Some contractors, such as Wisconsin Physicians Service (WPS), were rated the same whether acting as a legacy carrier or MAC; in fact WPS is top-rated in the survey.

Ask a Part B News Expert: Separate E/Ms billed with Mohs surgery

09/19/2011

Is it appropriate for a Mohs surgeon within the same group as the referring dermatologist to bill for a level 2 or level 3 E/M office visit on the same day that Mohs is performed? Under what circumstances would billing a level 2 and level 3 E/M be appropriate in addition to the Mohs procedure on the same day? Also, what documentation would be necessary to support this coding/charge?

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.