After getting over the initial sticker shock caused by the new conversion factor, you and your peers can take comfort in most of your Medicare payments remaining stable for 2011 because of legislative payment fixes passed and signed into law before the New Year. The conversion factor is $33.9764 for 2011, representing a 7.85% drop from the rate used during the last half of 2010. However, all of your reimbursements have not decreased by nearly 8%.

You are no longer required to offer patients a chance to discuss end-of-life planning as part of the new annual wellness visit (AWV), Part B News has learned. The change is effective immediately and was codified in a Federal Register rule Jan. 5.

You can get a head start on getting paid federal bonus money for implementing electronic health records (EHR) by registering your providers on a new CMS website immediately. The website is called the EHR Incentive Program Registration & Attestation System and you must use it to be paid the bonus.

Take a look at 16 new measures added to the Physician Quality Reporting System (PQRS, formerly PQRI) 2011 reporting year. These measures may represent a new opportunity to boost quality of care at your practice and earn a bonus equal to 1% of your Medicare charges next year.

Some specialties obviously bill more procedures than E/M codes, while others do the opposite. This chart examines this trend by looking at the ratio of E/Ms to procedures, in an effort to quantify and compare the gap between 16 specialties that were top Medicare billers in 2009.

You and your peers planning to use a registry in 2011 will have 11 new, registry-only measures available. Seven of these are new functional deficit measures, which will affect mainly orthopedic providers, while the other four impact dermatologists, cardiologists and thoracic surgeons.

You have to deal with three new codes for observation services in 2011, and their low pay combined with new CPT rules will result in less money - $14 to $68 less - when your providers initiate observation, experts tell Part B News. Providers who see patients in observation on a consulting basis will be less affected. The new codes are 99224-99226 (subsequent observation care, low, moderate and high severity respectively). Here's a brief rundown on how they fit into CPT 2011 rules for billing observation care.

Q. I am reviewing dictation from one of our specialty physicians for what should be a subsequent inpatient visit. The physician's states that the previous chart was reviewed and he also noted a discussion with the nurse on the patient's progress. There were apparently issues that came up overnight, so he looked at labs and X-rays and took other steps. The physician did not see the patient face-to-face, but planned a visit for the next morning. But when he went to examine the patient, the patient had left. In fact, the notes indicated that the patient kept threatening to leave. Can the doctor bill anything for this?