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Halt to RAC audits brings temporary relief, but other auditors loom

03/03/2014

Practices may not get as much of a break as they hope with the pause in recovery auditor (RAC) additional documentation requests (ADRs).

CMS to modify RAC rules

03/03/2014

by: Scott Kraft

In addition to halting recovery auditor (RAC) audit activity while the new contract bids are sought and contracts awarded, CMS proposed five changes to the rules by which the new RACs will operate.

Practices could lobby to join ICD-10 end-to-end testing, CMS hints

03/03/2014

by: Roy Edroso

Physicians may have a few ways to get involved in CMS’ end-to-end ICD-10 testing, despite the federal agency’s announcement that it would be open to a “small group” of providers.

Studies suggest stable, transparent practices benefit from ACO model

03/03/2014

by: Roy Edroso

If you’re a financially sound practice accustomed to teamwork and transparency, joining an accountable care organization (ACO) could help your practice provide higher quality care for less money, based on two HHS reports and some ACO managers.

OIG to look at face-to-face exam requirements for PMD prescriptions

03/03/2014

by: Scott Kraft

Review your documentation carefully when physicians prescribe power mobility devices (PMDs) to make sure the required face-to-face visit shows clear medical necessity for the device.

When billing injections with 96372, support with direct supervision

03/03/2014

by: Scott Kraft

Before you bill injection code 96372 for an injection that was done by a nurse, make sure that the injection was given under the direct supervision of a provider. If it wasn’t, you can’t support use of that code.

Part B News briefs

03/03/2014

by: PBN Staff

CMS extends “probe and educate” phase of new hospital two-midnight rule, and more.

Denials for G0372 and PMD prescriptions could catch OIG’s attention

03/03/2014

by: Karen Long

Compare your denial rates for G0372 (Physician service required to establish and document the need for a power mobility device [PMD]) with these specialties that bill the code most often to see whether your claims will draw auditors’ eyes.

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