Part B News | Part B News

Multi-shot season is chance to meet new patients, perhaps off-site

10/23/2023

Vaccine season is here, offering practices an opportunity to do effective, useful outreach even if they don’t expect patients to come to them for shots.

New CPT guidelines clarify same-day services in the facility setting

10/23/2023

by: Julia Kyles, CPC

Your 2024 CPT contains manual contains revised guidelines for multiple same-day E/M visits in the hospital or nursing facility settings, when performed by the same physician or qualified health care professional (QHP). But the update serves as a reminder that there are areas where the CPT manual and CMS rules don’t match up.

OIG audit another hint that feds are scoping MA claims

10/23/2023

by: Roy Edroso

A recent report on overpayments attributable to faulty Medicare Advantage (MA) coding is just the latest in a series of signs that HHS is paying closer attention to those claims. Although it’s the Medicare Advantage organizations (MAO) that are in the direct line of fire, providers may sustain some collateral damage.

Know time rules, medical necessity when reporting critical care services

10/23/2023

by: Jessica Miller-Dobbs, CPC, CPC-P, CGIC

Critical care coding is one of the most detailed specialties and can challenge both new and seasoned coders. The intricate details of the documentation take many coders by surprise and can be a challenge. To report critical care, coders need to understand the definition.

UHC HIPAA breach signals call to action for compliance departments

10/23/2023

by: Dom Nicastro

Heed a recent settlement between the Office for Civil Rights (OCR) and UnitedHealthcare (UHC). Experts say it serves as a stark reminder of the importance of HIPAA compliance and the right of patients to access their medical records in a timely manner.

First year of split or shared modifier reveals leaders in team care

10/23/2023

by: Julia Kyles, CPC

Emergency medicine providers are the top team players, according to analysis of Medicare data for modifier FS (Split [or shared] evaluation and management visit).

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