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Tool of the Month
Manny Oliverez, CEO of Capture Billing in South Riding, Va., swears by a cover letter his billers use on claims with the problematic 24 modifier, along with good documentation.
Take note of revisions to the procedures and services covered by the Stark Physician Self-Referral rule in the physician fee schedule and make sure your practice isn’t involved in problematic referral arrangements for them.
For your reference, here are the MUEs that took effect July 1 that affect primary care practices the most. As you can see, CMS has expanded its presentation of these edits. MUEs limit the number of units of service for which a code may be billed by a provider for the same patient during one calendar day.

Use this tool, provided by Nancy Enos, consultant and coding educator at Enos Medical Coding in Warwick, R.I., to ensure proper E/M coding. 

Use this chart to determine whether to use the 1995 or 1997 E/M guidelines for documenting your claims.
The first round of meaningful use audits has already begun for providers who already received their meaningful use incentive payment. Here is a copy of the spreadsheet file you'd use to submit your supporting documentation to CMS contractor Figliozzi & Company if you were to receive this intiial audit.

CMS’ proposed 2013 Medicare physician fee schedule boasts several changes, chief of which are new measures for the Physician Quality Reporting System (PQRS) program. Download Part B News’ tool detailing all 13 proposed quality measures via the “Download file” link. 


This month's tool is a comprehensive list of the average sales price (ASP) drug prices for the second quarter. You will be able to view an Excel file of the  the changes with the first quarter changes alongside for comparison.  A PDF version of the data is also available for download here.


This month's tool is a ready-to-use encounter form for your annual wellness visits tailored specifically for patients receiving their subsequent visit of this preventive service CMS initiated in 2011.


Struggling to collect from patients with high deductible health plans (HDHPs)? This tool gives you multi-faceted bullet points on how to develop a workflow process to improve collections from both new and existing patients.


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