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Make sure your practice is protected as CMS finalizes exclusion-for-debt rule
12/15/2014
by: Roy Edroso
The finalization of a Medicare enrollment rule puts your practice in danger of disruption if you haven’t tightened up your personnel practices.
 
Shift of values for 2015 new, revised codes means confusion for gastroenterology
12/15/2014
by: Scott Kraft
Gastroenterology providers are faced with the prospect of using two code sets when billing for lower GI procedures in 2015 — a set of G codes for Medicare and new and revised CPT codes for other payers.
Medicare issues new drug screen codes, sticks with 2014 payments
12/15/2014
by: Julia Kyles
Don’t throw out your 2014 guidance for coding quantitative drug tests. Providers who perform tests such as drug confirmation and quantitative drug screens will have to use two code sets next year, and it won’t be easy to cross-walk between the two. In addition to a new set of CPT codes for use by a number of private payers, you’ll need to use HCPCS codes that are modeled on the 2014 CPT codes to report your services to Medicare.
More news from AMA Symposium
12/15/2014
by: Laura Evans

CMS and AMA coding officials clarified policies last month at the AMA’s CPT and RBRVS 2015 Annual Symposium in Chicago (PBN 12/8/14). Here are two more points to note.

 
Fewer claims billed but more denials for initial AWVs in 2013 than 2011, 2012
12/15/2014
by: Karen Long
The number of initial annual wellness visits (AWVs) billed by practices dropped from almost 2.2 million when the code was introduced in 2011 to 1.5 million in 2013, the latest Medicare data show. But denials for the service (G0438) increased from 10.7% in 2011 to 20.1% in 2013, the data show.
 
CPT officials, CMS clarify CCM billing, E/M documentation, other 2015 changes
12/08/2014
by: Laura Evans

For the new monthly chronic care management (CCM) services, practices should bill the claim on “the last day of the calendar month for which the CCM service is billed,” according to a senior CMS official.

 
Target 6 documentation areas for transitional care services to avoid denials
12/08/2014
by: Richard Scott

When billing one of the two transitional care management (TCM) codes, stave off denials by ensuring proper documentation of medication reconciliation and key dates within the 30-day service window.

 
CMS rule proposes new ‘track’ to push more ACOs into risk-reward model
12/08/2014
by: Roy Edroso

A proposed new “track” for accountable care organizations offers more revenue potential for participants in the shared-savings program.

 
Treat new patients then keep them with your practice with a flu shot drive
12/08/2014
by: Roy Edrosor

Though you can’t expect much profit from it, you should take advantage of the season to reach out to new patients with a flu shot program.

 
Ensure proper support for claims with modifier 24 as scrutiny ramps up
12/08/2014
by: Roy Edroso
Take extra time to review claims with modifier 24 before billing them after a Medicare administrative contractor’s (MAC’s) probe showed high denial rates, which suggests increased scrutiny is coming.
 
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