Physicians who choose not to participate in an accountable care organization (ACO) must prepare for the impact of having an ACO operating in their area. When enough other practices doparticipate, the holdouts may be forced to join as referrals dry up or existing patients switch to ACO doctors.

Practices could lose more than $100 per month per home health patient because of incorrect billing of care plan oversight (CPO), and physicians who don’t think the effort is worth it could be leaving that amount on the table. Denials for G0181(home health care supervision, $104.84) are increasing at family practices. 

Save your practice time and potentially hundreds of dollars a year in interest fees by using a new form to let CMS automatically recoup overpayments instead of sending a check or accruing interest. But be extra diligent with your bookkeeping or risk giving CMS too much money, experts say.

This chart presents the 2010 and 2009 denial rates of 11 frequently billed modifiers. Based on a Part B News analysis of the latest Medicare claims data available, the graph shows you which modifiers have given you and your peers the most problems over time.

Do you need to document the time spent, in minutes, for smoke cessation counseling (99406-99407)? If so, is it sufficient for the provider to write, “three to 10 minutes counseling provided” or “>10 minutes spent counseling…”? Also, are specific counseling details needed or is it sufficient for the provider to write, “Smoke cessation counseling provided?”