Part B News | Ask a Part B News Expert

Monitor 2024 ICD-10-CM guideline revision for COVID-19

10/16/2023

Question: Are there any ICD-10-CM 2024 code or guideline updates related to COVID-19 screening or diagnosis?

Pay attention to Medicare POS limits for procedures in non-facility (office) setting

10/09/2023

Question: We had a provider perform an excision of prepatellar bursa (27340) in the office, place of service (POS) code 11. Patient has United Healthcare Shared Services-GEHA insurance. They denied the claim stating that CPT 27340 is not billable with POS 11. I have never had this issue before. Are there any coding rules/guidelines that prohibit use of some CPT codes at certain places of service or is this some weird payer-specific rule?

No LT for PAs: With one exception, locum tenens is physicians-only

09/11/2023

by: Roy Edroso

Question: Some of our clinical staff is going on vacation and we’re going to bring in locum tenens providers to cover for them. We have a physician assistant (PA) who wants us to swap in a fellow PA who freelances in a reciprocal billing arrangement. Can we do that?

Prepare for new telehealth place of service rules, document patient location

09/11/2023

by: Julia Kyles, CPC

Question: Which place of service (POS) code should we use for telehealth services in 2024?

Determine key tips for reporting SDOH in ICD-10-CM

08/07/2023

by: Savannah Schmidt

Question: What are some tips for organizations that are just starting out capturing the type of information to report social determinant of health (SDOH) diagnoses in ICD-10-CM?

Bundling policies likely to block pay for 99000

07/17/2023

by: Julia Kyles, CPC

Question: Our practice performs and bills for simple tests in our CLIA-waived lab. For more complex tests, the patient comes to the practice, we collect the specimen and send it to an outside lab. In both cases, storing and handling specimens takes extra time and expense. Can we bill 99000 (Handling and/or conveyance of specimen for transfer from the office to a laboratory)?

Count MDM risk level based on viable treatment options discussed at encounter

07/03/2023

by: Laura Evans, CPC

Question: When selecting the level of risk to code based on medical decision-making (MDM), the 2023 E/M guidelines state that you can count the risk of treatment options that were discussed but ultimately not chosen. We are wondering how much discussion must be documented in order to count toward risk? For example, our providers will list the treatment options and then document what was recommended and decided...

Calling patient with test results is not a telephone E/M service

06/26/2023

by: Julia Kyles, CPC

Question: Our physicians and nurse practitioners (NP) prefer to call patients with their test results rather than waiting until the next visit or delegating the task to a member of clinical staff. Most of the calls last at least five minutes, but some can take much longer. Our providers have said we should bill the calls as telephone E/M services (99441-99443) when the patient is a Medicare beneficiary or has a payer that covers telephone E/M. Is that permissible?

Want a J-1 visa doctor? Prepare to work (and pay) for it

06/26/2023

by: Roy Edroso

Question: We’re in a HPSA [health professional shortage area] and have trouble finding appropriate doctors. I’m told there’s a government program that allows qualified foreign doctors who want to work in the U.S. to do so if they commit to working in a HPSA. How do we get in on that?

PCP notification, not permission, is required for extended ESI treatments

06/12/2023

by: Julia Kyles, CPC

Question: We were told that we need to contact the patient’s primary care provider (PCP) before we perform epidural steroid injections (ESI) for Medicare patients. It’s hard to get the PCPs’ authorization for the injections. Where can we find proof that we need a PCP’s permission?

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.