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10/29/2012
 
Republican presidential candidate Mitt Romney would reduce the regulatory burden on practices by decreasing government involvement in health care, say supporters in a recent Part B News survey. “The Affordable Care Act [ACA] is not business-friendly,” says one respondent from a multispecialty practice.
10/29/2012
Maximize your electronic health record (EHR) note capabilities while avoiding upcoding and recoupment of E/M reimbursements by teaching your clinicians to properly input patient data and by customizing your templates to prevent abuses.
10/29/2012
Increase practice revenue by expanding your hours of operation into evenings or weekends, but make sure to budget your break-even point, staff the new hours and market the change to the community.
10/29/2012
You must now get preauthorization before rendering certain diagnostic cardiology tests to your UnitedHealthcare (UHC) Medicare Advantage patients. UHC’s new policy, which went into effect Oct. 1, aims to weed out unnecessary diagnostic tests that fail to meet Medicare’s medical necessity standard, the payer says.
10/29/2012
You’ll soon have seven new vaccine codes to use, in addition to six revised codes, according to the latest update to the CPT vaccine code list, issued in July by the AMA. All but one of the new codes are awaiting FDA approval, so you can’t bill them yet for payment.
 
10/29/2012
The charts below show the past three years’ overall denial rates for each E/M office visit code. The top chart presents the 2009, 2010 and 2011 denial rates from left to right for initial patient codes (99201-99205) while the bottom chart has the same data for established patient codes (99211-99215).
10/29/2012
Does the doctor have to be in the office suite if a physician assistant (PA) is billing services under that doctor’s national provider identifier (NPI)?
10/29/2012
Don’t risk a denial when your non-physician providers bill an annual wellness visit (AWV) and E/M service for the same patient on the same day. Maintain separate documentation of the two components of the visit – one that fulfills the AWV and one that addressed the patient’s unrelated complaint.
10/29/2012
Expect the same scrutiny of your non-physician practitioners’ (NPPs’) billing and payments from HHS’ Office of Inspector General (OIG) can as their physician counterparts. Review all six audit targets for NPP services on the OIG's 2013 Work Plan.
 
10/29/2012
These charts represent the E/M utilization for established patient codes (99211-99215) in 2009, 2010 and 2011 for both physician assistants (PAs) and nurse practitioners (NPs). The utilization for each code is presented from left to right in order of 2009-2011. All numbers come from a Part B News analysis of Medicare claims data.

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