Part B News | Part B News

No EHR? No problem. Avoid MU penalties for 2015 by filing a hardship exception

03/07/2016

Question: We don’t currently work out of an electronic health record (EHR). Would we qualify for the hardship exception or is it for those eligible professionals (EPs) that are actually using an EHR and can’t attest?

Primary care, specialty docs see rising denials on core pulmonary tests

03/07/2016

by: Richard Scott

Primary care physicians had a difficult time getting their claims through for spirometry code 94010 (Measurement and graphic recording of total and timed exhaled air capacity) and two other pulmonary-testing codes that practices billed frequently in 2014, the most recent year of available claims data.

8 tips to handle patient requests for records without violating HIPAA

02/29/2016

by: Marla Durben Hirsch

Prepare for more patients and their families to ask for copies of their medical records. HHS’ Office for Civil Rights (OCR) recently issued guidance reminding consumers they’re entitled to the documentation.

Specialists can perform lung cancer screening, despite guidance to the contrary

02/29/2016

by: Richard Scott

Specialty providers can order a certain lung cancer screening for their patients and get reimbursed for the newly covered preventive service, despite language issued in MLN Matters 9246 stating otherwise.

Look to registry reporting now; be ready when CMS releases the 2016 list

02/29/2016

by: Julia Kyles, CPC-A

Practices need to weigh the cost of alternative quality reporting methods against the risk of flubbing quality reporting in 2016. This year, any group that employs at least one physician could face a combination of cuts totaling 6%, based on quality reporting.

Avoid turning off LGBTQ patients, prevent lawsuits with ‘cultural competency’

02/29/2016

by: Roy Edroso

A pending law in the District of Columbia underlines your obligation to proactively guard against discrimination against lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) patients — or risk alienating patients or even legal trouble.

Watch for high-denial surgery, post-op modifiers on E/M claims

02/29/2016

by: Roy Edroso

While modifier 25 (Significant, separately identifiable E/M services) is often the cause of denied E/M claims, other common modifiers have been known to crash and burn such claims.

Clarification

02/29/2016

Part B News clarifies meaningful use attestation policy.

Don’t let inconsistent, incomplete LCDs trigger denials and delays

02/22/2016

by: Laura Evans

More than four months into ICD-10-CM use, coders report that that their biggest headaches are being caused by insurance company payment policies that are at best inconsistent and at worst just plain incorrect in their ICD-10-CM code reporting requirements.

Implement 6 tips to correctly bill dual-eligible patients, avoid sanctions

02/22/2016

by: Richard Scott

Verify your patients’ insurance coverage to avoid getting sanctioned over balance-billing rules that restrict you from obtaining Part B copayments, deductibles and coinsurance from patients in the qualified Medicare beneficiary (QMB) program.

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