Home | News & Analysis
Part B News
10/01/2010

Some staff members say we can charge an E/M visit prior to a screening colonoscopy if the physician needs to address a co-morbidity and adjust Coumadin, manage diabetes, etc. There seems to be a lot of different opinions. What does CMS state?

10/01/2010

There are now three different groups that have government approval to certify electronic health record (EHR) systems for meaningful use. InfoGard Laboratories, an information technology firm that specializes in electronic security testing, got the green light from the HHS Office of the National Coordinator for Health Information Technology (ONC) Sept. 17.

10/01/2010

This chart examines the change in denial rates for 10 high-utilization services between 2008 and 2009, based on the latest CMS claims data from 2009. NOTE: Codes billed fewer than 1 million times annually were excluded from analysis. NOTE: To ensure a wide range of specialties were represented, several high-denial, high-utilization physical therapy codes were excluded, despite having higher denial rates than some of the codes shown.

10/01/2010

Practices that are hospital owned will want to take a close look at the recent expansion of Medicare's "three-day payment window" for hospitals. That's because if your practice comes under Medicare's definition of being "wholly owned or operated" by a hospital, you could find your physicians' services bundled into the hospital inpatient payment if the patient is admitted up to three days after the office visit.

10/01/2010

Reports of health care fraud against your practice can lead to a payment suspension, according to a new anti-fraud proposal from CMS. The agency already has the ability to suspend your payments for up to 180 days when it suspects fraud, but now CMS wants to define exactly what constitutes a credible allegation of fraud.

10/01/2010

The number of E/M services billed to Medicare increased in 2009 over 2008 levels, reversing a trend of E/M declines that began in 2006, a Part B News analysis of the latest CMS data from 2009 shows. Total E/M utilization increased by 452,832 services, or just 0.19%, in this one-year period.

10/01/2010

Not all referred Medicare patients you see will be referred by a doctor enrolled in the Medicare program. That won't stop CMS from denying services you provide to these patients unless the referring provider goes through a new modified enrollment application process.

10/01/2010

Look for incentive payments rewarding your practice for participation in 2009 electronic prescribing and Physician Quality Reporting Initiative (PQRI) programs to start arriving in your bank accounts if they haven't already. Several of your peers have reported receiving thousands of dollars in bonus checks for the e-prescribing program during the last week of September.

10/01/2010

There are 130 new ICD-9 codes effective Oct. 1 that you and your peers must start using as there is no grace period for implementing these codes. Most of the proposed ICD-9 code changes from April were finalized (PBN 4/26/10), but you will also find a few additions to the list to use this flu season.

Login

User Name:
Password:
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Back to top