Part B News | Part B News

Navigate the HIPAA Right of Access rule: Compliance essentials

07/15/2024

Despite the number of security incidents that have occurred over the past few years — including cybersecurity breaches, phishing attacks and malware — access to records still remains one of the top five complaints in HIPAA compliance.

CPT says you can separately report decompression at same level

07/15/2024

by: Lynn Anderanin, CPC

Question: Does Medicare allow CPT code 22630 (Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace [other than for decompression], single interspace, lumbar) and add-on code 63052 (Laminectomy, facetectomy, or foraminotomy, during posterior interbody arthrodesis, lumbar; single vertebral segment) to be reported at the same level?

Denial rates edge up as claims fall for critical care codes

07/15/2024

by: Richard Scott

Despite a decrease in the number of claims for critical care services that medical groups billed to Medicare Part B, denial rates have inched up over a recent four-year stretch.

Info blocking ‘disincentives’ rule brings penalties; data-sharing adjustments needed

07/08/2024

by: Roy Edroso

Against loud protests from medical organizations, HHS has finalized strong “disincentives” — that is, financial punishments — for providers who commit what OIG, the designated overseer, determines to be information blocking.

Use 7 tips to bring staff up-to-speed on new diabetes screening rules

07/08/2024

by: Julia Kyles, CPC

Train your team on the latest definitions and coding guidance for diabetes screening and related services during your next training session. And be prepared to follow up on denials of diabetes screening tests performed after Jan. 1, 2024. New guidance from CMS includes the new definition for diabetes, coverage for 83036 (Hemoglobin; glycosylated [A1C]), also known as HbA1c, for diabetes screening and looser frequency limits.

Fake CMS fax scam: Vet faxes like emails; check, then click

07/08/2024

by: Roy Edroso

A CMS warning on a “fax phishing” scam reminds you that the noisy little machines are still very much a part of health care and you should train staff to check out the provenance of sensitive faxes as they would sensitive emails.

Be careful of patients seeking Wegovy with suspect heart complaints

07/08/2024

by: Roy Edroso

Question: We have some patients asking questions about Wegovy (semaglutide) coverage. In some instances they apparently want it for weight loss, but suggest they might be suffering from heart trouble in ways that lead us to believe they’re just looking to get it covered by Medicare Part D, which will not pay for it otherwise. Do we need to have a policy for this?

HIPAA Q&A: Secure business associate agreements

07/08/2024

by: Rebecca Herold, CDPSE, FIP, CISSP, CIPM, CIPP/US, CIPT, CISM, CISA, FLMI

Question: How can health care entities ensure their business associate agreements (BAA) fully address the cybersecurity risks and responsibilities related to PHI protection?

Weak pay raises for lower-level clinical staff, especially MAs, RNs

07/08/2024

by: Roy Edroso

A new Medical Group Management Association (MGMA) survey finds that while increased patient volume presents challenges for many practices, pay rates for medical assistants (MA) who can help ease that pressure have only risen slightly in the past year. Over the same period, other clinical and nursing staff did better.

Change Healthcare’s long-delayed breach notice gives providers new footing

07/01/2024

by: Roy Edroso

Four months after an epic hack that affected thousands of provider practices across the country, Change Healthcare started sending breach notifications to covered entities. This offers some assurance to practices that may have felt at sea in the interim — but experts caution they still have work to do.

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