It’s no joke. April 1 is the effective date for a new, nationwide Medicare policy designed to minimize Place of Service (POS) errors that have vexed the HHS Office of Inspector General (OIG) for years. Chief among these changes is a new rule for how you’ll assign the place of service code when your physicians interpret diagnostic results of tests performed outside of your office.

Accurately schedule annual wellness visits (AWVs) as either initial or subsequent this year, or else you’ll spend unwanted time and money on the back end fixing unnecessary denials. If you’ve been billing AWVs frequently in 2012, you’ve probably already noticed tremendous patient confusion as to whether they’ve had an AWV before or if this is the initial visit. If the patient is new to your practice then you can’t rely on the patient’s memory. Even your elderly patients with sharp mental acuity could still easily mix up the AWV with the Initial Preventive Physical Examination.

Payment disruptions started affecting practices across the country after the industry switch to HIPAA 5010 on Jan. 1. Some early-converting practices are missing payments from as early as November 2011. Root causes for delayed or non-payments run the gamut from payer system failures to missing claims’ status responses and are as varied as the different payers themselves.

You could say the new place of service (POS) policy was inevitable. CMS first announced it would issue revised guidance for POS selection in response to the audit report the HHS Office of Inspector General (OIG) released in September 2011, and while implementing the new rules may increase your work load, you should make sure doctors are aware of that repeated POS errors increase their risk (see related story).

This chart shows how all 50 states plus Washington, D.C. fared at scheduling annual wellness visits (AWVs) in the first year Medicare offered the free preventive service to patients. The AWV utilization rates were derived by dividing the total number of AWVs performed in 2011 in each state by the state’s total number of Part B enrollees.

Reports out of Washington this week indicate Congress has reached an agreement to extend the physician fee through 2012. As this issue went to press, Congress had not yet voted on extending the payroll tax bill which lumps in a temporary fee fix for Medicare providers, but the reported agreement on the fix was set to be voted on by Feb. 17 at the latest. If Congress fails to extend the bill by Feb. 29, then you’ll see an automatic 27.4% Medicare pay cut.

How do you determine the National Drug Code (NDC) unit of measure (UOM) that is now required on HIPAA 5010 claims? Do you break it down to the HCPCS dosage or do you use the UOM per the vial dosage?