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Meaningful Measures program may change reporting measures in 2019

12/11/2017

In a Nov. 28 provider call, CMS said its Meaningful Measures program would lead to no new, revised or deleted reporting measures for 2018 — but it will affect the way measures are created after that.

7 ways to avoid Stark for lab work, imaging and other ancillary services

12/11/2017

by: Marla Durben Hirsch

Be prepared for more scrutiny if your practice performs ancillary services such as metabolic panels, X-rays or physical therapy. A variety of ancillary services are defined as designated health services (DHS) under the Stark physician self-referral law and can trigger costly penalties.

GOP tax overhaul plan takes big step forward by getting Senate approval

12/11/2017

by: Joshua Poltilove

Before sending a final bill for President Donald Trump to sign, the U.S. House and Senate must work to reconcile versions of tax overhaul bills they recently passed.

Most-reported 59-appended services find fewer claims denials

12/11/2017

by: Richard Scott

Give yourself a pat on the back for work well done. By and large, practices that reported multiple procedures on the same date of service performed admirably in 2016, according to a Part B News analysis of recently available Medicare claims data.

The latest training opportunities from Part B News and DecisionHealth

12/11/2017

You'll find training opportunities on a range of issues, from vaccine coding and billing to understanding how and when to use an advance beneficiary notice.

For post-op on someone else’s surgery, bill for service – but not for E/M

12/04/2017

by: Roy Edroso

Question: We often see patients who had surgery in St. Louis and come to us for post-operative X-rays rather than driving back for X-ray check-ups. One of our PAs recently saw a patient who falls into this scenario. The patient is still in the global period, but we are not taking over post-operative care. Can we charge an office visit or just the X-ray?

Lighting the E/M fuse: Looming guideline changes foretell a new era in reporting

12/04/2017

by: Richard Scott

Peer into the distance and you may catch a glimpse of an entirely new way to chart your patient encounters. Over the course of the 2018 rulemaking period, CMS has laid out the preliminary groundwork that would bring its official E/M documentation guidelines full-bore into the 21st century in a shift that, while slow in the making, could mean a significant change in the way practices report — and get paid for — their most common services.

Combine CCM with BHI, outside partners as utilization takes off

12/04/2017

by: Roy Edroso

As a second-year growth spurt in the use of the chronic care management (CCM) code 99490 suggests that the code is here to stay, look to some innovations to make the service more beneficial to your patients and to your bottom line.

New E/M subsections further define, limit 2018 CPT code changes

12/04/2017

by: Richard Scott

Take note of additional guidance on a suite of new E/M codes making their debut in 2018 after the AMA released an array of reporting limitations, billing restrictions and other updates to the CPT codes effective Jan. 1.

CCM claims double in 2016 — and most specialties have low denial rates

12/04/2017

by: Roy Edroso

The second year in which CMS paid for the chronic care management code 99490 saw a big increase in use — and even providers in specialties that seem ill-suited for the service had little trouble getting it accepted.

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