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5 steps to get your claims paid post-Oct. 1 if your tech isn’t ready for ICD-10

09/21/2015

An employee at a single-doctor practice recently contacted Part B News, complaining that her electronic health record (EHR) vendor had confirmed it would not be ready to accommodate ICD-10 codes Oct. 1.

Denials, utilization on E/M codes by specialty show NPPs advancing

09/21/2015

by: Roy Edroso

Increasing utilization and low denial rates for some non-physician practitioners (NPPs) stand out in a Part B News analysis of E/M codes in the newest 2014 claims data — and should be of interest to practices looking to expand their clinical staff.

PQRS informal review period starts, but hardship exemptions no longer available

09/21/2015

by: Scott Kraft

Individual providers and group practices facing a 2% payment penalty in 2016 for not meeting Physician Quality Reporting System (PQRS) requirements may ask CMS for an informal review of their reporting data to see whether corrections could wipe out the penalty.

Stick to coverage guidelines to get paid for at-home colon cancer screening

09/21/2015

by: Richard Scott

Make sure your patients have neither a positive colonoscopy in their records nor a family history of colon cancer to clear any barriers to getting paid for the Medicare-covered at-home stool test that you can run every three years.

Expanding outreach drives ACO outcomes, financial success; money helps too

09/21/2015

by: Roy Edroso

The experience of one of the more successful accountable care organizations (ACOs) in CMS’ recent report suggests that it pays for an ACO to invest heavily in extensive provider networks and in tools to support them — and if you can’t afford that, you should consider a less ambitious pay-for-performance model first.

E/M office visit denial rates move little but financial impacts are big

09/21/2015

by: Roy Edroso

Most denial rates for office E/M codes (99201-99215) were flat from 2013 to 2014, with three exceptions.Code 99211 had denial rates that jumped from 11% to 14%, 99201 increased from 31% to 33% and 99203 went from 10% to 11%, according to the latest Medicare claims data.

Correction

09/21/2015

From the Sept. 14 Part B News.

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