Part B News | Part B News

Opt for unspecified codes as last resort; track your codes to improve accuracy

05/16/2016

Be careful when you choose to report unspecified ICD-10 codes and put a strategy in place to monitor your performance to keep a high level of compliance even after the current ICD-10 flexibility period ends Oct. 1.

Have the cost talk with your patients to improve care, prepare for value

05/16/2016

by: Richard Scott

Hone your office-wide strategy to discuss medical costs with your patients so you can mitigate potential cost barriers and position your practice for success in the evolving shift to value-based care.

Sample estimate forms

05/16/2016

Need help giving your patients a clear estimate of surgery or procedure prices? Check out these sample forms.

MIPS and APMs offer mutually exclusive reporting, payment tracks

05/16/2016

by: Richard Scott

If you choose to participate as an advanced alternative payment model (APM) under Medicare’s new reimbursement structure, you won’t have to report any measures under the merit-based incentive payment system (MIPS) — even if you want to.

You probably don’t have to take workers’ comp cases — unless they sneak in

05/16/2016

by: Roy Edroso

Question: A patient has come in with a work-related injury that he says he intends to submit to workers’ compensation. Can I refuse to treat him?

Working under multiple TINs could multiply a provider’s PQRS burden

05/16/2016

by: Julia Kyles, CPC-A

Question: A nurse practitioner works for Practice A on Monday and Wednesday. He works for Practice B on Tuesday and Thursday. Practice A wants its providers to participate in the physician quality reporting system (PQRS) via a registry this year, but Practice B still uses claims-based reporting. He feels this is creating extra work. Will he flunk PQRS if he only reports measures for the patients he sees at Practice A?

Special rules for controlled substance samples may not be worth risk, hassle

05/16/2016

by: Scott Kraft

The regulatory and paperwork requirements for dispensing samples of controlled substances out of the office are likely more trouble than they’re worth, especially considering many of these prescriptions won’t cost the patient a lot of money and the lion’s share of office visits occurs while pharmacies are available to quickly fill prescriptions.

Brief: Drug wastage coding requirements tightened

05/16/2016

by: Roy Edroso

A CMS transmittal issued April 29 may change your billing on unused portions of drugs. Starting July 1, all providers must use modifier JW “to identify discarded drugs and biologicals when processing Part B claims."

Denials trend down on post-operative E/M, ophthalmologic codes

05/16/2016

by: Richard Scott

Your post-operative coding likely saw a performance boost in 2014 compared with the previous year, as providers came away with a nearly unanimous decrease in denials related to modifier 24 (Unrelated E/M service by the same physician or other qualified health care professional during a post-operative period) over the two-year period.

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