Part B News | Part B News

Tech tools, financial help and ‘high touch’ can turn med-avoiding patients around

04/08/2019

Results of a new survey suggest patient medication adherence can be a problem for even day-to-day long-term therapies. While there are some novel tech solutions for the problem, provider involvement remains a powerful tool to keep your patients taking their pills.

Part B services in the hospital demand attention, offer counseling opportunity

04/08/2019

by: Richard Scott

When it comes to services rendered within a hospital setting, you should be prepared to explain to your patients the financial nuances of the billing process and how that may impact their out-of-pocket costs. In some cases, your patients may be looking to their trusted physicians for guidance.

Meet strict definitions when reporting modifier 50 for bilateral services

04/08/2019

by: Richard Scott

Sharpen your modifier reporting when you conduct bilateral procedures to know when you should turn to — or avoid using — modifier 50 (Bilateral procedure) to avoid claims issues that will impact your payments.

Say hello to new claims adjustment, remittance advice remark codes

04/08/2019

by: Richard Scott

You may have noticed new codes on your claims from two families of remark codes: claims adjustment reason codes (CARCs) and remittance advice remark codes (RARCs). Effective March 1, CMS introduced two CARCs and modified one RARC to help explain your claims changes and denials.

‘Do-over’ on this split procedure is probably a start-over, too

04/08/2019

by: Roy Edroso

Question: An emergency department physician treated a dislocated shoulder reduction (23655) and billed with modifier 54 (Surgical care only), as the patient’s orthopedist would be handling follow-up care with modifier 55 (Postoperative management only). The patient returned to the ED two months later having fallen and dislocated the same shoulder. Our ED physician once again reinserted the shoulder using closed manipulation. How should the second service be reported?

Eye docs most likely to report surgery-only modifier 54 for strict surgical care

04/08/2019

by: Richard Scott

Select few specialists, most notably ophthalmologists, report the bulk of procedural services with modifier 54 (Surgical care only), which denotes the work tied to the pre-operative and intraoperative pieces of the surgical puzzle.

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