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New SAMHSA rule reduces required consent for substance abuse records

01/15/2018

Appropriate sharing of records for patients with substance abuse disorders should be easier under a second final rule issued Jan. 3 by HHS and its Substance Abuse and Mental Health Services Administration (SAMHSA). But in some cases, the new rule adds some considerations that might mitigate the advantage.

Specialists spread the love on modifier 25-appended E/M claims

01/15/2018

by: Richard Scott

Physician practices received significant payments — more than $4 billion — on 10 frequently reported E/M services performed the same day as a minor procedure or other service, according to a review of 2016 Medicare claims data, the most recent available.

Congress unlikely to cut Medicare, patients’ coverage this year -- but states may act

01/08/2018

by: Roy Edroso

Despite high-level talk of cuts to Medicare and Medicaid and a recent blow to the Affordable Care Act (ACA), you don’t need to worry too much about further cuts to federal programs in 2018. But do watch for state-level changes that could impact the way your patients’ coverage works.

Keep track of time to seize payment for new add-on codes to preventive services

01/08/2018

by: Richard Scott

With the introduction of two new codes in 2018, you’ll find a pathway to reporting the extra time your physician or clinical staff spends with patients during an encounter involving Medicare-covered preventive services, such as an annual wellness visit (AWV) or lung cancer screening.

CMS proposes changes to Medicare Advantage scoring, new and revised HCCs

01/08/2018

by: Roy Edroso

If you serve mental health or nephrology patients on Medicare Advantage plans, take notice of a CMS proposal to change Medicare Advantage risk adjustment.

Limit post-op billing when provider changes practices during global period

01/08/2018

by: Richard Scott

Question: A surgeon performs a procedure at one practice location. He then leaves that practice, transitioning to a new practice during a patient’s 90-day global period. The second practice is an entirely new group with a new tax ID. When the physician starts at the new practice and sees his patient from the first practice for routine follow-up care, how do we report those post-op visits? Can they be reported separately?

E/M use for top M.D.s dropped in 2016 — but NPPs’ use rose

01/08/2018

by: Roy Edroso

Top specialties saw office E/M utilization go down between 2014 and 2016, the most recent year for which we have Medicare data — except for the two top-billing categories of non-physician practitioners (NPP).

From the Part B News blog

01/08/2018

by: Richard Scott

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.

Providers take on risk, OCR goes after ‘juicy’ violations, MIPS habits change and more

01/01/2018

by: Roy Edroso and Richard Scott

Part B News editors surveyed readers and interviewed experts to come up with 11 predictions of what will affect physician practices in 2018. Find out what's in store with a look as Medicare Advantage is expected to expand, the merit-based incentive payment system (MIPS) may get tougher and more.

PBN’s 2017 predictions: Right on QPP, CCM, fraud — and almost everything else

01/01/2018

by: Roy Edroso and Richard Scott

Part B News did well, if we do say so ourselves, in its predictions for health care in 2017, though it’s too early to tell the results in some cases. Here’s a round-up of how we did.

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