Part B News | Part B News

‘No comment’ sounds guilty. Fight bad impressions with a press policy.

09/09/2024

Question: Recently one of our providers was in the news and reporters called our office. We all refused to comment when contacted. That seemed the safest course, but now we’re wondering if we should have done something else.

Take key lessons learned from latest high-dollar Security Rule settlement

09/09/2024

by: Dom Nicastro

The Office for Civil Rights (OCR) has reached a $950,000 settlement with Heritage Valley Health System Inc. for potential violations of the HIPAA Security Rule, following an OCR investigation after the health system experienced a ransomware attack in 2017.

Surgical, postop-only claims almost even for transfer of care cases

09/09/2024

by: Julia Kyles, CPC

Billing practitioners who do not treat patients during a procedure’s full global period are slightly more likely to report claims with surgical care-only modifier 54 than with postoperative care modifier 55, according to Medicare Part B claims data.

MACs reveal 8 mistakes that still endanger your office E/M revenue

08/26/2024

by: Julia Kyles, CPC

Protect your office/outpatient E/M claims from front-end denials and post-payment recoupments with the freshest information from Medicare administrative contractors (MAC).

Prepare: New DOJ pilot pushes non-FCA fraud reporting, with an online form

08/26/2024

by: Roy Edroso

A new whistleblower pilot threatens to “supercharge” the range of qui tam suits brought against health care entities. Confer with your business insurers, counsel and compliance officers to prepare.

Find insights on HIPAA final rule on reproductive health care privacy

08/26/2024

by: Dom Nicastro

The final rule “HIPAA Privacy Rule to Support Reproductive Health Care Privacy“ aims to safeguard sensitive protected health information (PHI) in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. This landmark ruling has far-reaching implications, particularly in states with restrictive reproductive health laws, prompting a critical need for enhanced privacy protections.

Modifier 78 continues its slide, though most codes have 0% denials

08/26/2024

by: Roy Edroso

The Medicare billing numbers show a precipitous pandemic-era drop in utilization of modifier 78 (Unplanned return to the operating room by the same physician following initial procedure for a related procedure during the postoperative period). You may have expected that losing trend to slow as America began to recover from the pandemic in 2022. It did, but not by much. The total number of 78 citations slid from 65,857 in 2021 to 51,177 in 2022, a 22% loss.

Include Oct.-effective excludes note updates in your diagnosis education

08/19/2024

by: Julia Kyles, CPC

Include training on the new ICD-10-CM excludes notes before the next update goes into effect on Oct. 1. The new tabular addenda for the FY2025 code set contains 18 new and eight deleted Excludes1 notes.

Proposed digital therapy codes good idea with barriers: Experts

08/19/2024

by: Roy Edroso

Experts say the latest Medicare innovations in behavioral health, including one that would pay for patients to use “digital therapies” such as apps, are sensible and welcome. But it remains to be seen how quickly these services would reach the beneficiaries who need it.

CMS revamps place of service for depression screening services

08/19/2024

by: Julia Kyles, CPC

Take note of pending billing changes for Medicare’s depression screening service G0444 (Annual depression screening, 5 to 15 minutes).

Login

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