Part B News | Part B News

Technology, tests, agreements among ways to help physicians spot potential opioid abuse

04/18/2016

With new opioid prescribing guidelines and a new focus on opioid abuse in the 2016 presidential campaign, practices should be aware of the tools available to fight the drug epidemic.

Put cost, quality data to use to outperform your peers for VBM incentives

04/18/2016

by: Richard Scott

Investigate and select the physician quality reporting system (PQRS) measures that you can report successfully to give your value-based modifier (VBM) payments a boost and avoid penalties that reach as high as 6%.

Most practices tally average value-based modifier scores, while outliers score big

04/18/2016

by: Richard Scott

You can gain incentives under Medicare’s value-based modifier (VBM) program if you outperform your peers on cost and quality metrics, and those incentives can be significant — some practices earned incentives that were a 32% increase on all Medicare payments.

The Stark Reality: Unassigned codes, delayed Medicaid payments and more

04/11/2016

by: Stark Medical Audit and Consulting

The following revenue audit findings are the latest from Stark Medical Auditing and Consulting.

Change policies and culture to discourage providers, others from working while sick

04/11/2016

by: Scott Harris

Reduce the likelihood clinicians will spread pathogens to patients by setting clear policies on working while sick and establishing a culture that discourages the practice.

Rehearse plans, plug leaks to prepare for press calls after an EHR hack

04/11/2016

by: Roy Edroso

A recent hack at a health care chain shows how easy it is for news about your practice to spread — and the importance of a solid communications protocol to maintain some control over the coverage you get.

Heed size, local coverage policies to reduce denials for debridement coding

04/11/2016

by: Richard Scott

Pay close attention to the size of wound-related surgical procedures and get a handle on your local payer policies to cut debridement denials down to size.

Check your lesion-removal claims with melanoma diagnoses

04/11/2016

by: Richard Scott

Providers in North Carolina, South Carolina, Virginia and West Virginia should double check their lesion-removal claims, as their Medicare administrative contractor (MAC) Palmetto GBA is adding melanoma-related diagnosis codes to its list of accepted ICD-10 codes for lesion-removal services.

Surgical debridement code denials improve — but they’re still awful

04/11/2016

by: Roy Edroso

The surgical debridement codes referenced in the coding story on p. 1 — 11042-11044, which report the service for up to 20 square centimeters and 11045-11047, which report the service for more than 20 square centimeters — all have bad denial rates.

Use expanded list of ICD-10 codes to get osteoporosis-screening claims paid

04/04/2016

by: Richard Scott

Update the list of ICD-10 diagnosis codes you’re eligible to report with a commonly billed bone mass measurement code to stave off costly denials.

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