Part B News | Part B News

Enrollment application timelines favor using Web-based PECOS application

09/01/2014

If you’re thinking about switching to Medicare’s online system to enroll new providers and revalidate or update provider enrollment instead of the traditional CMS-855 paper forms, here’s an extra incentive — your application may be processed faster when done online.

Watch for appropriate use of G modifiers as MACs increase attention

09/01/2014

by: Roy Edroso

Ensure your claims accurately portray the services your practice provided — even if you attach a G modifier because you don’t believe you’ll be paid for it. Auditors are paying new attention to those cases.

CMS issues dates for ICD-10 acknowledgment testing weeks

09/01/2014

CMS will allow acknowledgment testing at any time before the Oct. 1, 2015, ICD-10 deadline, but it instructed Medicare administrative contractors (MACs) to promote it during three specific weeks:

CMS hasn’t done enough to reduce duplicative post-payment audits

09/01/2014

by: Ben Hartman

Because most of the post-payment audits are conducted by RACs, CMS created a database to track RAC activities to prevent duplicative reviews, but the data is unreliable.

Psychologist unable to collect unemployment benefits after HIPAA breach

09/01/2014

by: Ben Hartman

A decision to deny unemployment benefits to a psychologist who lost a flash drive with protected health information (PHI) on it was upheld Aug. 4 by an appeals court.

MACs start fingerprint background checks

09/01/2014

by: Ben Hartman

MACs are requring “individuals with a 5% or greater ownership interest in a provider or supplier that falls into the high-risk category and is currently enrolled in Medicare or has submitted an enrollment application,” according to MLN Matters article SE1427 (PBN 6/30/14).

Denial rates on claims with G modifiers increase from 2010 to 2012

09/01/2014

Because modifiers GA, GX, GY and GZ involve claims on which the provider is anticipating denials, it may surprise you to learn that claims with those modifiers haven’t come near 100% denial rates in recent years.

4 new HCPCS modifiers act as subset of modifier 59, could reduce denials in 2015

08/25/2014

by: Scott Kraft

The addition of four new modifiers to clarify distinct procedural services is a huge improvement that should reduce denials and abuse of modifier 59, experts tell Part B News.

Reach out to allies to improve interoperability, avoid stage 2 penalty

08/25/2014

by: Roy Edroso

If you’re not ready to share electronic health records (EHR) documentation with other practices, hospitals and ambulatory surgical centers (ASCs), you’re not alone — but you risk a 1% pay cut for failing to meet stage 2 meaningful use measures if you don’t call for help soon.

CMS proposal could cut fees for orthotics supplied in your office

08/25/2014

by: Laura Evans

If your orthopedic practice employs athletic trainers, medical assistants or certified orthotic fitters to fit custom orthotics that you dispense in your office, look out for a CMS proposal that could reduce reimbursement for those services.

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