Expect Congress to stop the 27.4% cut to your Medicare physician payments before 2012, and replace it with two years of 0% updates. You face even more uncertainty for 2013, thanks to a new wrinkle introduced in the law passed to raise the U.S. debt ceiling in August. That law resulted in Congress creating a Super Committee that was supposed to deliver a plan for $1.2 trillion in deficit reduction over 10 years.

You’ll still get paper faxes, paper lab results, paper mail and patients waving paper forms after adopting an electronic health record (EHR) system – slowing you down and limiting your EHR’s effectiveness. The best solution is to use a combination of scanning paper documents, having physicians convert the most important data to EHR, and to work with paper-based practices to develop a better way, experts say.

Your hospital-affiliated practice will lose time and money next year on non-diagnostic services rendered three days prior to a hospital admission, according to the 2012 Medicare Physician Fee Schedule final rule. CMS finalized its proposal to lump Medicare Part B-billed services hospital-owned or operated entities render into a three-day payment window policy originally reserved only for hospitals.

If your practice is in the habit of “brown bagging” drugs for in-office administration, be aware that for fee-for-service Medicare, at least, this practice will be officially against the rules starting Jan. 1, 2012. Some physician practices write scripts and send the patient to an outside pharmacy to pick up expense injectable drugs and the practice bills for the injection.

Expect fewer headaches when it comes to taking on referred patients now that CMS finalized an enrollment form for non-Medicare ordering or referring physicians. The new CMS-855O form, proposed back in May and released Oct. 27, allows non-Medicare billing providers to refer patients to Medicare-enrolled participants without having to enroll in Medicare.

This chart examines a total of 20 modifiers, 10 of which had some of the highest denial rates in 2010 and 10 which had some of the lowest, comparing their 2010 rates with 2009. NOTE: Because 2010 was the first year in which CMS no longer accepted consult codes (99241-99255), the new modifier AI (principal physician of record). Thus, there is no 2009 data for this modifier, which is added to inpatient claims billed by the admitting physician. Adding modifier AI lets contractors know the services were furnished by the admitting physician who coordinates care, distinguishing them from services done by others who also see the patient.

CMS Administrator Donald Berwick, M.D., will officially resign his post effective Dec. 2, CMS says. News of the departure leaked Nov. 23 before CMS’s formal announcement. Berwick will be succeeded by Marilyn Tavenner, currently CMS’s principal deputy administrator, who has previously acted as administrator.

What is the correct way to code multiple trigger joint injections into the same site? Our physician gave patient 10 injections and we billed 20610 (arthrocentesis, aspiration and/or injection; major joint or bursa) times 10 units along with 1 unit of the medication and the claim was denied.