Part B News | Part B News

Expect updated PECOS features to make enrollment easier next year

10/06/2014

CMS is planning some big changes for the Provider Enrollment, Chain and Ownership System (PECOS) in 2015 — including letting providers change their business names within the system, having those changes automatically feed into other systems and requiring all Part D providers to enroll or opt out in PECOS.

Watch for drops in prices of commonly billed drugs in Q4 ASP pricing

10/06/2014

by: Roy Edroso

You’ll get 17% less when billing a popular code for Vitamin B12 injections, according to the average sales price (ASP) drug pricing update for the fourth quarter of 2014.

Biggest gains, drops in ASP pricing from Q3 to Q4 2014

10/06/2014

by: Roy Edroso

The top ten gainers and losers in CMS' Q4 ASP drug pricing release.

Circumstances guide whether pre-op visit can be billed when surgery canceled

10/06/2014

by: Scott Kraft

Don’t bill for pre-operative visits when surgeries are canceled unless you can establish the service as being medically necessary on its own.

When providers get in trouble, keep quiet until it’s resolved, then reach out

10/06/2014

by: Roy Edroso

If one of your physicians leaves the practice under a cloud, even if his or her alleged offense directly affects your patients, be careful about releasing information about the situation to patients and staff until you have legal clearance to do so.

Part B providers have most success appealing RAC decisions at first level

10/06/2014

by: Karen Long

While almost 62% of Part B providers had denied claims overturned at the first level of appeal, just 18% had success at the second level.

EHR attestation site issue threatens some providers with unexpected 1% penalty

09/29/2014

by: Roy Edroso

A glitch in CMS’ electronic health records (EHR) attestation website has put many first-time meaningful use attesters in jeopardy of a 2015 negative payment adjustment of 1%.

4 ways to get in on those great new ACO savings — even without joining one

09/29/2014

by: Roy Edroso

You can improve your costs of care by following the formulas of successful accountable care organizations (ACOs), which have qualified for shared-savings payments of $445 million.

You’ll need a modifier to bill cath placement, studies with embolization

09/29/2014

by: Laura Evans

Vascular embolization and occlusion codes 37241-37244 — added in this year’s CPT manual — received a number of new component codes in Version 20.3 of the National Correct Coding Initiative (CCI), which takes effect Oct. 1.

Hepatitis C screening approved for coverage; pay details may take until Nov.

09/29/2014

by: Scott Kraft

You now can bill and get paid for hepatitis C screening tests for high-risk patients and for one lifetime test for any patient born between 1945 and 1965. But it may take until November to know how much you’ll get paid for the lab test, billed with new code G0472.

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