Part B News | Part B News

Survey says: Part B News readers going for the gold in MIPS 2018

01/01/2018

CMS will allow merit-based incentive payment system (MIPS) participants to turn in a minimum amount of data to avoid penalties, but Part B News’ 2018 Predictions Survey shows practices are far more likely to go for a positive payment adjustment. And a surprising number appear to be involved in value-based care models.

Hundreds of lab codes expected to earn less revenue in 2018 as cuts take hold

12/18/2017

by: Richard Scott

If your practice performs lab tests, you may be in for a dose of sticker shock in 2018 as hundreds of codes are expected to see reduced payments under a Medicare fee-schedule change.

MedPAC reaffirms opposition to MIPS, support of APMs; will Congress heed?

12/18/2017

by: Roy Edroso

The Medicare Payment Advisory Committee (MedPAC) again called to get rid of the merit-based incentive payment system (MIPS) and replace it with a program more tailored toward pushing providers into alternative payment models (APMs).

Limit modifier KX reporting to successfully file immunosuppressive drug claims

12/18/2017

by: Richard Scott

Firm up your claims reporting for patients on immunosuppression drug therapy to avoid payment denials and the possibility of inflicting financial duress on patients who recently have undergone organ transplants.

Be precise on vaccine claims, set up self-pay to ensure correct reporting

12/18/2017

by: Richard Scott

Set up a plan to easily document and report your vaccine coding, including a collections plan for vaccines not covered by Part B, and you’ll avoid claims disruptions that can cause extra work among your staff.

For new patients, OK to report multiple new-patient codes for same encounter

12/18/2017

by: Richard Scott

Question: My office is having a debate. Let’s say a new patient has an office visit and physical at the same appointment. Is this coded with one new and one established code or two new codes?

Providers bill — and earn — millions on oft-reported immunosuppressive drugs

12/18/2017

by: Richard Scott

Providers billing immunosuppressive drug claims saw some — but not much — resistance to the several hundred millions of claims they submitted in 2015 and 2016, according to an analysis of Medicare claims data from the two most recently available periods.

From the Part B News blog

12/18/2017

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.

Update unit-of-service, modifier 59 reporting, says 2018 CCI manual

12/11/2017

by: Richard Scott

Incorporate new guidance contained in the 2018 Correct Coding Initiative (CCI) policy manual to accurately report on a range of coding topics — including modifier 59 (Distinct procedural service), immunizations and debridement services — and stay in compliance with CMS’ policies next year.

At first hearing, HHS pick Azar knocks ACA, vows to fight Medicare waste

12/11/2017

by: Roy Edroso

In his first confirmation hearing before the Senate Committee on Health, Education Labor & Pensions (HELP) on his nomination to be secretary of Health and Human Services, Alex Azar was often vague and even evasive as to policy specifics, but he did indicate he would cleave to the Republican line on the Affordable Care Act, women’s health and other health policy issues.

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