Part B News | Part B News

Shared Savings offers ‘prepaid’ plan, health equity tweak, more

07/22/2024

In the 2025 physician fee schedule proposed rule, the Medicare Shared Savings Program (MSSP) is trying a few new things, including a program to let more MSSP accountable care organizations (ACO) get their savings up front — but at a price.

Caregiver training featured among new HCPCS codes

07/22/2024

by: Richard Scott

CMS seeks to maintain a focus on behavioral health management, debuting a range of new HCPCS codes that, should they become finalized, would add a bevy of new billing opportunities for Part B providers come Jan. 1, 2025.

Sepsis aftercare code finalized as part of FY2025 ICD-10-CM code update

07/15/2024

by: Megan Herr

Effective Oct. 1, coders will now have a way to capture a post-acute encounter for sepsis aftercare with the new code Z51.A (Encounter for sepsis aftercare).

CMS fact sheet outlines CERT documentation requirements

07/15/2024

by: Son Hoang

CMS recently released an updated MLN fact sheet reminding providers about documentation requirements for requests from its Comprehensive Error Rate Testing (CERT) program.

Ensure compliant documentation, coding for critical care services

07/15/2024

by: Hamilton Lempert, M.D.

The ED is a demanding setting where split-second decisions must be made. For coders and providers, this means data must be gathered and synthesized quickly when life-or-death outcomes hang in the balance. Consider the following coding and reporting guidance for ED critical care to ensure the documentation accurately represents the services.

Navigate the HIPAA Right of Access rule: Compliance essentials

07/15/2024

by: Dom Nicastro

Despite the number of security incidents that have occurred over the past few years — including cybersecurity breaches, phishing attacks and malware — access to records still remains one of the top five complaints in HIPAA compliance.

CPT says you can separately report decompression at same level

07/15/2024

by: Lynn Anderanin, CPC

Question: Does Medicare allow CPT code 22630 (Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace [other than for decompression], single interspace, lumbar) and add-on code 63052 (Laminectomy, facetectomy, or foraminotomy, during posterior interbody arthrodesis, lumbar; single vertebral segment) to be reported at the same level?

Denial rates edge up as claims fall for critical care codes

07/15/2024

by: Richard Scott

Despite a decrease in the number of claims for critical care services that medical groups billed to Medicare Part B, denial rates have inched up over a recent four-year stretch.

Info blocking ‘disincentives’ rule brings penalties; data-sharing adjustments needed

07/08/2024

by: Roy Edroso

Against loud protests from medical organizations, HHS has finalized strong “disincentives” — that is, financial punishments — for providers who commit what OIG, the designated overseer, determines to be information blocking.

Use 7 tips to bring staff up-to-speed on new diabetes screening rules

07/08/2024

by: Julia Kyles, CPC

Train your team on the latest definitions and coding guidance for diabetes screening and related services during your next training session. And be prepared to follow up on denials of diabetes screening tests performed after Jan. 1, 2024. New guidance from CMS includes the new definition for diabetes, coverage for 83036 (Hemoglobin; glycosylated [A1C]), also known as HbA1c, for diabetes screening and looser frequency limits.

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