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Advance preview -- 5 tips for getting vendors’ ICD-10 timelines for software changes

07/23/2013

Medical practices and their vendor partners aren’t talking about ICD-10 – and that could be slowing down your preparations for the Oct. 1, 2014, coding changeover, say experts.

Advance preview -- Withstand auditor scrutiny with 7 ways to bolster your E/M documentation

07/22/2013

by: Roy Edroso

Check common problems and use physician education to keep your high-level E/M coding from getting out of hand and attracting the attention of Medicare administrative contractors (MACs).

Fall of DOMA gives more same-sex spouses health benefits — but not right away

07/22/2013

by: Roy Edroso

The end of the Defense of Marriage Act (DOMA) will increase the number of patients who will be able to obtain health coverage and seek treatment at practices, experts say. But for now, at least, those changes appear to be confined to states where same-sex marriage is already recognized.

Beef up documentation to justify E/M with procedures to prepare for new code pairs

07/22/2013

by: Laura Evans

If you haven’t worried much about denials when reporting E/M codes with your surgical procedures because no National Correct Coding Initiative (CCI) edits bundled them — here’s a heads up: Now they do.

Check therapy coverage policies to determine whether to give patient ABN

07/22/2013

by: Karen Long

Use local coverage determinations (LCDs) and policy manuals to determine whether the therapy services you provide above the $3,700 threshold are medically necessary. If not, issue an advance beneficiary notice of noncoverage (ABN).

Keep track of PECOS data to avoid delayed or revoked payments

07/22/2013

by: Roy Edroso

HHS’ Office of Inspector General (OIG) has found that provider data in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and National Plan & Provider Enumeration System (NPPES) are a mess – and CMS’ response may be trouble for practices down the road.

Enrollment rules clarified around partnerships, director title

07/22/2013

by: Scott Kraft

Next time you are enrolling a group practice or revalidating enrollment information, know the difference between a member of your group practice’s board of directors and a person who has “director” in his or her title. It could save you from making an error in section 6 of your CMS-855B group enrollment form, CMS clarified in a recent transmittal.

Benchmark: Impact of proposed 2014 Medicare physician fee schedule by specialty

07/22/2013

by: PBN staff

See how your specialty fares under the proposed 2014 Medicare physician fee schedule.

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