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Alert: NIST publishes Cybersecurity Resource Guide for HIPAA security compliance

05/20/2024

The National Institute of Standards and Technology (NIST) published NIST SP 800-66 Rev. 2 in February. You can turn to the publication to gain practical guidance and to safeguard health information and better understand the security concepts discussed in the HIPAA Security Rule.

G0136 joins select group of codes cleared for use with modifier 33

05/20/2024

by: Roy Edroso

A new billing policy requires that modifier 33 (Preventive services) appear with the social determinants of health (SDOH) assessment add-on code G0136 on all such claims submitted with annual wellness visits (AWV). This will mean a big change in that modifier’s utilization, which has mainly been limited to four codes (and overwhelmingly used for just one).

Use 4 team-based care scenarios to refresh your billing knowledge

05/13/2024

by: Julia Kyles, CPC

Medicare’s rules for incident-to and split/shared services give your practice the opportunity to gain extra revenue for a non-physician practitioner’s (NPP) work. But the chance to receive 100% of the physician payment when an NPP does all or some of the work for an encounter comes with the risk of significant pain if members of your practice, including physicians and NPPs, don’t follow the rules.

Ortho CPT coding Q&A: Know units of service, payer policies to capture pay

05/13/2024

by: Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC

Lynn Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, an independent medical coding education consultant, answers some of the many questions she receives pertaining to physician coding for CPT orthopedic services.

HIPAA Q&A: Vendor risk management, reproductive health care, and telehealth

05/13/2024

by: Julia Huddleston, CIPP/US, CIPM, CCSFP

In this issue, Part B News welcomes compliance expert Julia Huddleston, CIPP/US, CIPM, CCSFP, principal with Apgar & Associates, to answer a series of questions about HIPAA compliance areas, focusing on vendor risk management, reproductive rights and telehealth policies. The Q&A session is below.

CMS summary of Q1 2024 HCPCS Level II update includes 48 new codes

05/13/2024

by: Savannah Schmidt

CMS published a summary of its first quarter 2024 HCPCS Level II code update application decisions. There were 48 additions, two code definition revisions and seven discontinuations. The additional codes mostly consist of injection and skin substitute products.

Subsequent hospital codes top combo with split/shared modifier

05/13/2024

by: Richard Scott

A clarification to the rules for split or shared billing took effect Jan. 1, and a look back at the most-billed codes in claim year 2022 reveals the most frequent locations and types of encounters that groups should keep a close eye on.

FTC’s labor-market rule ends most noncompetes for physicians, if it clears

05/06/2024

by: Roy Edroso

On April 24 the Federal Trade Commission (FTC) unveiled a final rule that essentially ends noncompete agreements of the sort that allow medical organizations to keep employed physicians from working for their competitors after they leave. While legal challenges from pro-business interests promise to tie the rule up for a while, it’s vital to know what the rule does and does not prohibit.

After FTC rule bans noncompetes, legal expert discusses direct impact

05/06/2024

by: Roy Edroso

On April 24 the Federal Trade Commission (FTC) previewed its final rule on noncompete agreements (NCA), which effectively bans the practice for most workers in for-profit businesses. The rule would have a direct effect on the restrictive covenants that practices often use to prevent departing physicians from setting up shop nearby.

PrEP now: CMS urges providers to prepare for a shift to Part B coverage

05/06/2024

by: Julia Kyles, CPC

Watch for a new Medicare Part B benefit designed to prevent human immunodeficiency virus (HIV) infection. Consider whether your practice should offer the services and be ready to answer your patients’ questions.

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