Congress may miss another deadline, leading to a devastating 21% cut to Medicare reimbursements. The House of Representatives and Senate had not yet agreed on a bill delaying the sustainable growth rate (SGR) cut to your payments set for April 1 as Part B News went to press.

Your efforts to implement an electronic health record (EHR) system and snag up to $44,000 in federal bonus money could get a big boost from new, government-funded entities called health information technology regional extension centers (RECs).

The Patient Protection and Affordable Care Act includes several anti-fraud, abuse and waste provisions, including reducing to 12 months the amount of time you have to submit a claim to Medicare. The new law is projected to save Medicare billions of dollars through fraud prevention.

Here's a bullet list of key changes that the health reform bill (dubbed "The Patient Protection and Affordable Care Act") will make to Medicare program fees.

Brace yourself for nearly 2,200 new Correct Coding Initiative (CCI) edits that take effect April 1 and largely target codes billed by ophthalmologists and optometrists. Most of these are new edit pairs that permit unbundling surgical services with a modifier. For comparison, CCI 16.0 had almost 42,000 changes, which means version 16.1 has 95% fewer changes.

Summary: Denial rates for both diagnostic and screening colonoscopies crept upward for the five specialties that bill the vast majority of these services to Medicare, an analysis of the most recent claims data shows. Most of the increases in denials are small, but consistent across the three-year period from 2006-2008.

Your Medicare payments should increase by 1% in 2011, the Medicare Payment Advisory Commission (MedPAC) argues in its annual report. However, MedPAC's recommendations are nonbinding, even though it makes its recommendations directly to Congress.

This week's question is answered by Sean Weiss, CPC, vice president, DecisionHealth Professional Services.

Q. When a doctor who is aware of a patient's financial situation recommends that we waive the patient's co-pay and/or deductible, do we also need to gather documentation that shows the patient is a true hardship case?

Billing E/M visits in lieu of consultation codes will yield lower reimbursement in most cases. But now CMS states you can bill consult scenarios as a split/shared service - a departure from previous agency policy fueled by the fact that the agency no longer pays these services as consults, but as regular E/M services.