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Changes to incident-to rules CMS proposes could mean adjustments for practices

07/13/2015

Practices that rely on non-physician practitioners (NPPs) and auxiliary medical staff to stretch their revenue may have to adapt to new processes if CMS goes through with proposed incident-to changes. The agency intends to tie billing to the supervising provider for incident-to services.

CMS tells doctors: Close enough is good enough for one year in ICD-10

07/13/2015

by: Roy Edroso

The dream of a “grace period” for ICD-10 users came partially true with a surprise joint announcement from CMS and the AMA promising that Medicare contractors “will not deny” claims that lack certain specificity in ICD-10 for one year after Oct. 1.

Rural, small practices gain opportunity in Medicare’s ACO Investment Model

07/13/2015

by: Richard Scott

Because of late-breaking changes to Medicare’s newest accountable care venture, more practices are now eligible to reap a sizeable chunk of change to invest — or continue to invest — in the infrastructure necessary to operate a successful accountable care organization (ACO).

OIG looking at whether shared savings groups exchange data to coordinate care

07/13/2015

by: Scott Kraft

One of the most important elements of effective care coordination in a shared-savings program is that participants share information about the patient’s condition to prevent duplicative tests and unnecessary visits and hospitalizations.

Watch out on double-booking CCM as CMS guides hospitals in proposed OPPS rule

07/13/2015

by: Roy Edroso

New guidance from CMS may encourage some hospitals to claim chronic care management (CCM) on practice patients, including yours; make sure your patient isn’t over-served.

Understand the difference between CCI edit, medically unlikely edit

07/13/2015

by: Laura Evans

Question: What is the difference between a CCI edit and a medically unlikely edit (MUE)?

CMS: Final ICD-10 acknowledgment testing week was successful

07/13/2015

by: Josh Poltilove

CMS accepted 90% of test claims during its final ICD-10 acknowledgment testing week, and no Medicare fee-for-service (FFS) claims systems issues were identified, the federal Medicare agency announced July 2.

Watch out when billing E/M, procedure together on new patient codes

07/13/2015

by: Karen Long and Roy Edroso

Make sure you can support an E/M service separately from a procedure for new patients or risk denials.

Correction

07/13/2015

Proposed 2016 Medicare physician fee schedule

07/09/2015

Click the "download file" link to see a copy of the proposed 2016 Medicare physician fee schedule.

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