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Practices consolidating quickly, study says; collaborate, seek options to stay independent

09/26/2016

Smaller practices better start thinking seriously about their survival strategy in the new world because practice consolidation is accelerating, according to a new study.

Oct. 1 changes make smoking cessation easier — but watch out for denial traps

09/26/2016

by: Roy Edroso

Replace the G codes you’ve been using to bill for smoking cessation counseling of patients who smoke but are asymptomatic (G0436, G0437) with two CPT codes as of Oct. 1, CMS tells Part B News.

New, updated limits placed on cardio, genetic counseling, injection codes

09/26/2016

by: Richard Scott

Pay attention to billing restrictions placed on genetic counseling and several percutaneous coronary intervention (PCI) codes to stay in compliance with Correct Coding Initiative (CCI) version 22.3 edits, which place new limitations on per-day services.

Medically unlikely edits, CCI v22.3 scorecard

09/26/2016

by: Richard Scott

Changes effective Oct. 1.

Expect more scrutiny of deals between physicians, home health agencies

09/26/2016

by: Marla Durben Hirsch

Revisit agreements your practice has with home health agencies in light of the HHS Office of Inspector General’s (OIG’s) new alert about improper arrangements and conduct between home health agencies and physicians.

New vs. established: How to bill a new patient for IPPE, E/M in same encounter

09/26/2016

by: Roy Edroso

Question: A new patient comes for his Welcome to Medicare visit and a medical problem. This is his first time at the office. Do we bill “new patient” for the Initial Preventive Physical Exam (IPPE) and “established patient” for the E/M? Are there any circumstances under which a patient may go from new to established in the same encounter?

Contact your payer about vitamin B-12 injections if billing issues persist

09/26/2016

by: Richard Scott

Question: I’m confused about billing vitamin B-12 injections. An elderly patient was receiving 2,000 mcg every two weeks because of health issues. Our practice began receiving denials stating that Medicare would only pay for 1,000 mcg, as stipulated in our payer’s local coverage determination (LCD). Now the LCD is retired. In the meantime, the physician wants the patient to receive 1,000 mcg weekly. Can anyone shed light on this for me?

Most vitamin B-12 denial rates down while payments nudge up

09/26/2016

by: Richard Scott

Primary care providers, who bill vitamin B-12 injection code J3420 most often, saw a cut in denials and a gain in reimbursement between 2014 and 2015, which are the latest two years of available Medicare claims data.

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