Part B News | Part B News

As practice burnout boils over, take bold steps to hold and head it off

10/31/2022

Even as pandemic pressures fade, symptoms of burnout in medical providers are getting worse rather than better, recent findings show. Practices that want to stem the tide should take advantage of tested methods and metrics — as well as some more imaginative ones — to help hold the line.

CMS seeks comment on payer-agnostic data directory with potential provider savings

10/31/2022

by: Roy Edroso

A request for information (RFI) for a payer-agnostic provider directory is a sign that CMS is pushing harder for an interoperability standard in health care data exchange that also will include private payers.

Let the reason for the encounter drive coding for ED visits

10/31/2022

by: Julia Kyles, CPC

Question: How do you report emergency department visits by a provider who is not on the emergency department staff?

Virtual incident-to visits are still a choice during COVID-19 PHE

10/31/2022

by: Julia Kyles, CPC

Question: We conducted a sample review of claims for 2021 and found two visits that were performed by the physician assistant (PA) but billed incident-to on days when the physician was not in the office. When we investigated, we found more claims with the same problem. According to the documentation for each visit the physician was at home but “present” through a real-time, audio/visual Zoom connection. Is there an exception that allows us to bill incident-to this way?

Virtual incident-to is an option through 2023

10/31/2022

by: Julia Kyles, CPC

Physicians can provide virtual direct supervision thanks to one of the many waivers that CMS created in response to the COVID-19 pandemic. Virtual direct supervision gives the practice more flexibility to bill incident-to services, but it is not a permanent policy.

Check state scope laws on who may debride mycotic nails

10/31/2022

by: Laura Evans, CPC

Question: I would like clarification on whether only MDs, DPMs, APRNs or PAs are allowed to perform and bill Medicare for debridement of mycotic nails (codes 11720 and 11721) in the office setting, when all the other criteria for the procedures have been met. Recently, I have been asked about a nail technician or medical assistant performing these procedures under supervision of a MD or DPM and billing the services to Medicare as incident to. I have found no information to suggest that this is appropriate. Am I correct in stating that nail technicians or medical assistants are not qualified to perform this service?

CMS releases deductible, premium rates for CY2023

10/31/2022

by: Richard Scott

On Oct. 13, CMS published 2023 rates for Medicare Part B premiums and deductibles, and beneficiaries will see a slight decrease in out-of-pocket costs compared to current-year rates. The 2023 Part B deductible will be $226.00, a modest decrease from the revised 2022 amount of $233.00.

After emergency medicine, PCPs and surgeons take over ER

10/31/2022

by: Julia Kyles, CPC

Thanks to popular media, the public may think that physicians and nurses who specialize in emergency medicine are the only providers who work in the emergency department. But the latest Medicare Part B data for emergency department E/M visits (99281-99285) reveals that members of any specialty can and do provide emergency department services.

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