You and your peers all want to secure $18,000 per provider in federal electronic health record (EHR) incentive bonuses by the end of 2012, a desire that will overwhelm the relatively young EHR vendor industry, experts tell Part B News. Take these five steps now to ensure your practice gets what it needs to earn $18,000 per provider by the end of 2012.

The technical component (TC) of your advanced imaging claims will be denied if you fail to get accredited for every CPT code you bill, and enrollment could prove tedious and time consuming, experts tell Part B News. Unaccredited technical components of advanced medical imaging services billed for services furnished on or after Jan. 1, 2012 will be denied, a CMS official says. 

There is no distinct service or visit code to pay you directly for end-of-life planning. And you’re no longer required to offer patients a chance to discuss it, since that’s been dropped from the annual wellness visit. But you may be able to ratchet up your revenue if you have these discussions with patients by reporting them under the Physician Quality Reporting System (PQRS).

This chart looks at how denial rates for top-dollar, high-utilization imaging services are impacted by the place of service (POS). NOTE: A total of four POS codes were used, office (11), outpatient hospital (22), inpatient hospital (21) and emergency room (23). These were combined into inpatient/emergency room and outpatient/office to make the data more accessible at a glance. NOTE: The imaging codes were chosen based on a combination of their annual Medicare utilization and total value in Medicare dollars paid, based on CMS claims data from 2009.

The majority of your peers are not yet ready to meet stage 1 meaningful use criteria, but you only have 17 months to achieve meaningful use if you want a crack at the first electronic health record (EHR) incentive check, worth $18,000. More than half of practices don’t yet have an EHR system, while 75% of those that do say they aren’t ready to meet meaningful use, according to a recent nationwide survey (see main story).

 

Your peers seem to find accountable care organizations (ACOs, see main story) an interesting concept and a possible source of new revenue – but they also see them as a major addition to a plate already crowded with health reform changes, electronic health records (EHRs), meaningful use and the switch to ICD-10. These results, taken from the most recent unscientific Part B News survey on the ACO proposed rule, show that many practices are following ACOs closely; 90% of respondents say they have read either a detailed analysis of the rule or a brief summary. NOTE: The survey is likely biased by respondents who tend to be more familiar with the rule.

 

Two physicians from same group with the same tax ID number see the patient in observation status. The first physician is on call and admits the patient to observation, then turns care over to his partner, who is the patient’s primary physician. The partner sees the patient on the subsequent observation day. Can this second physician use the subsequent observation day codes even though he was not the admitting physician? This is not a consulting scenario, but a transfer of care from one partner to the other within the same group.