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Further refinements ahead for value modifier, Physician Compare programs

07/10/2014

All practices would be subject to the value modifier next year based on their participation in the physician quality reporting program (PQRS), and doctors should watch for more tweaks to the Physician Compare website, according to the proposed 2015 Medicare physician fee schedule (see story).

New chronic care payments, changes to global periods in proposed fee schedule

07/08/2014

by: Roy Edroso and Julia Kyles

Your practice could earn almost $42 per patient every 30 days for chronic care management (CCM) as long as your clinical staff jump through the proper hoops to bill a new G-code, including being available 24/7.

6 spending ‘black holes’ to seal at your practice when revenue drops

07/07/2014

by: Roy Edroso

When your practice needs to scale back expenses, don’t cut willy-nilly; first check some common “black holes” where money tends to disappear.

OIG clamps down on payment arrangements between physician practices, labs

07/07/2014

by: Marla Durben Hirsch

Your revenue could take a hit if your physicians receive payments from clinical labs for blood specimen collection, processing and packaging or for services to a registry or database maintained by a lab. The HHS Office of Inspector General (OIG) appears to be restricting those deals in a Special Fraud Alert.

6 dos and don’ts when hiring a locum tenens provider this summer

07/07/2014

by: Scott Kraft

With summer vacation season in full swing, practices will engage locum tenens physicians to fill in for absent doctors. While locum tenens, which is Latin for “to hold the place of,” is the fastest way allowed by Medicare to get temporary help into your practice, you risk billing errors if you don’t know the rules.

CMS, experts bust myths about PECOS enrollment that lead to preventable errors

07/07/2014

by: Ben Hartman

If you have been signing the Provider Enrollment, Chain and Ownership System (PECOS) forms on behalf of your provider, stop it.

Watch for revenue bumps as majority of ASP drug prices increase in third quarter

07/07/2014

by: Scott Kraft

You’ll see more money starting July 1 for most of the drugs paid under Medicare’s average sales price (ASP) payment formula, according to a Part B News analysis of the pricing file released by CMS.

Little consistency in price changes of top billed drugs under ASP

07/07/2014

Now in its ninth year, CMS’ methodology of average sales price (ASP) plus 6% for paying for Part B covered drugs often results in pretty big price shifts, even from one quarter to the next.

July 1 E/M webinar: Stop E/M undercoding and documentation mistakes

06/30/2014

by: Part B News staff

The Office of Inspector General (OIG) identified undercoding as a major problem in physician practices in its latest report. Undercoding not only puts you at risk for audits but means you miss out on revenue your practice deserves. Join our health care expert July 1 for detailed guidance to ensure you're not leaving thousands of dollars on the table through improper E/M undercoding. Click here to learn more.

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Watch for new bundles for skin lesion, imaging and stent placement codes

06/30/2014

by: Laura Evans

Take care when reporting lesion destruction codes with other skin procedures because the latest quarterly update to the National Correct Coding Initiative (CCI), effective July 1, includes a number of new code pairs involving those codes.

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