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CMS tells doctors: Close enough is good enough for one year in ICD-10

07/13/2015

The dream of a “grace period” for ICD-10 users came partially true with a surprise joint announcement from CMS and the AMA promising that Medicare contractors “will not deny” claims that lack certain specificity in ICD-10 for one year after Oct. 1.

Rural, small practices gain opportunity in Medicare’s ACO Investment Model

07/13/2015

by: Richard Scott

Because of late-breaking changes to Medicare’s newest accountable care venture, more practices are now eligible to reap a sizeable chunk of change to invest — or continue to invest — in the infrastructure necessary to operate a successful accountable care organization (ACO).

OIG looking at whether shared savings groups exchange data to coordinate care

07/13/2015

by: Scott Kraft

One of the most important elements of effective care coordination in a shared-savings program is that participants share information about the patient’s condition to prevent duplicative tests and unnecessary visits and hospitalizations.

Watch out on double-booking CCM as CMS guides hospitals in proposed OPPS rule

07/13/2015

by: Roy Edroso

New guidance from CMS may encourage some hospitals to claim chronic care management (CCM) on practice patients, including yours; make sure your patient isn’t over-served.

Understand the difference between CCI edit, medically unlikely edit

07/13/2015

by: Laura Evans

Question: What is the difference between a CCI edit and a medically unlikely edit (MUE)?

CMS: Final ICD-10 acknowledgment testing week was successful

07/13/2015

by: Josh Poltilove

CMS accepted 90% of test claims during its final ICD-10 acknowledgment testing week, and no Medicare fee-for-service (FFS) claims systems issues were identified, the federal Medicare agency announced July 2.

Watch out when billing E/M, procedure together on new patient codes

07/13/2015

by: Karen Long and Roy Edroso

Make sure you can support an E/M service separately from a procedure for new patients or risk denials.

Correction

07/13/2015

Proposed 2016 Medicare physician fee schedule

07/09/2015

Click the "download file" link to see a copy of the proposed 2016 Medicare physician fee schedule.

More patients, bigger practices likely the long-term outcome of King v. Burwell

07/06/2015

by: Roy Edroso

The Supreme Court’s King v. Burwell decision that allowed the continuation of Obamacare subsidies via federal exchanges is expected to maintain and perhaps increase not only the influx of patients to physician practices, but also the pace of change in the practice market, leading to greater consolidation, experts tell Part B News.

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