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Talk-to-text EHR alternatives get fancier — but watch the basics when you buy

05/21/2018

If you haven’t adopted a talk-to-text module for your electronic health record (EHR), consider both the virtues and the drawbacks — and recent innovations that may change your providers’ whole relationship to the technology.

Medicare pays for foot orthotics — but under strict conditions

05/21/2018

by: Roy Edroso

Question: We have a podiatrist who is having custom orthotics made for his patients. We have been using L3000 (Foot, insert, removable, molded to patient model, ‘ucb’ type, berkeley shell, each) per his instructions, but Medicare is denying the claims. These orthotics are custom-molded insole inserts. What are we doing wrong?

Foot orthotics hard to bill — unless they meet strict standards

05/21/2018

by: Roy Edroso

The difficulty of getting paid by Medicare for foot orthotics is obvious when you look at the denial rates on related codes. This is obvious from the chart below of codes for foot inserts — including L3000 (Foot, insert, removable, molded to patient model, ‘ucb’ type, berkeley shell, each), with which a reader was having trouble in this issue’s Ask Part B News story (see p. 4).

Direct primary care references in new CMS program plan leave cash-only docs skeptical

05/14/2018

by: Roy Edroso

A CMS program currently in planning stages appears to seek input from the direct primary care (DPC) community — but DPC providers Part B News talked to aren’t sure they see how their model would fit.

ALJ appeals backlog is growing, but several big changes may help providers

05/14/2018

by: Josh Poltilove

Despite HHS’ efforts to reduce the backlog of appeals at the Administrative Law Judge (ALJ) level, the average processing time for appeals has continued to grow. But now, providers caught up in — or contemplating entering — the massive backlog of appeals have several reasons to jump for joy.

CMS opens up telehealth billing sites, including home, for some dialysis patients

05/14/2018

by: Richard Scott

Certain providers who treat patients with end-stage renal disease (ESRD) will soon be clear of telehealth billing restrictions and eligible to provide video-based encounters to patients at their homes, as well as other sites of service.

Millions gained from ESRD management codes as billing restrictions loosen

05/14/2018

by: Richard Scott

SNF patient in your office? Bill MAC for E/M, SNF for technical services

05/14/2018

by: Roy Edroso

Question: If Medicare beneficiary enrolled in a skilled nursing facility (SNF) under Part A goes to see a practice physician in her office and the doctor performs E/M and an X-ray, orders a lab test and prescribes a drug, how would each of these services be billed by that physician’s office?

From the Part B News blog

05/14/2018

Take note of the news that happens between Part B News issues by checking out the free Part B News blog. Here’s a sampling from this week.

Despite uncertainty, practices accelerate into the wide-open world of value-based care

05/07/2018

by: Richard Scott

The journey was not easy, nor is it complete, but the rewards are beginning to pile up for AMITA Health’s accountable care organization (ACO), a network in suburban Chicago that offers a striking example of the risk-and-reward environment underpinning health care’s seemingly unstoppable shift to value-based care.

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