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Avoid a PQRS reporting surprise; check your EHR vendor’s submission capability

03/23/2015

Don’t let a common misconception about Physician Quality Reporting System (PQRS) submission requirements submarine your year-end data reporting, which could leave you on the hook for big penalties in the years to come.

‘Next Generation’ ACO model speeds up P4P transition — and your need to adapt

03/23/2015

by: Roy Edroso

While you may find CMS’ new accountable care organization (ACO) model is too tough for your practice, you should pay attention to this “Next Generation” model anyway because it points to a pay-for-performance future for all Medicare providers.

For injections, ensure decision-making supports billing separate E/M service

03/23/2015

by: Scott Kraft

Be careful when you routinely bill an E/M service along with an injection done during the same encounter. E/M services are typically bundled into most injection codes, and you need to establish separate medical necessity to support billing the E/M service.

More than 150 new codes have daily limits, but they aren’t without appeal

03/23/2015

by: Julia Kyles

Don’t forget to revise your billing system and remind staff to watch for reporting limits on services and supplies, such as fluid drainage and tendon sheath injections, that were added to the medically unlikely file that goes into effect April 1.

CCI update contains new joint injection, myleography edits

03/23/2015

by: Julia Kyles

Don’t ignore the edit update that goes into effect April 1 just because it contains only 1,106 new pairs. The edits may impact the way you report the new joint injection codes, among other changes.

Payment per claim shows ups, downs for commonly billed injection codes

03/23/2015

Providers on average saw a 17.3% jump in pay per claim for injections of medium joints (20605) in 2013 over the previous year.

MACs: You can bill some charges on translation service — but follow the rules

03/23/2015

by: Roy Edroso

Translation or interpretation services are, from the perspective of HHS’ Office for Civil Rights (OCR), something Part B providers are obliged to give to patients who need them. But some contractors have given providers guidance on what they can bill for the extra time these services may incur.

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