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Patient discharge hard cases: An expert’s view

08/28/2023

When it comes to ‘firing’ patients, dangerous and uncooperative patients are in most cases an easy call. But what about patients who through no fault of their own may be difficult for a practice to handle? Patricia A. Markus, a partner with the Nelson Mullins law firm in Raleigh, N.C., shares her expertise on such cases.

Practices mull compensation shake-ups even as split/shared change waits

08/28/2023

by: Julia Kyles, CPC

CMS will allow providers to determine the substantive portion of a split/shared visit based on performance of a key element for another year. The delay may temporarily calm fears that time-based substantive portion calculations will equal serious cuts to physician pay and practice revenue.

Q&A: Master risk analysis, information system activity reviews and more

08/28/2023

by: Rebecca Herold

Part B News welcomes compliance expert Rebecca Herold to answer a series of questions pertaining to critical HIPAA compliance areas, such as risk analysis and risk assessment.

Medicare Advantage flexes power-up vs. traditional Medicare

08/28/2023

by: Roy Edroso

The latest CMS Medicare Enrollment Dashboard figures show Medicare Advantage (MA) about to overtake traditional Medicare in membership – and at least one major health care analyst group thinks it already has.

Medicare MOVEit breach a warning of persistent cyber-danger; watch impact

08/21/2023

by: Roy Edroso

A data breach at a Medicare subcontractor is bad news for affected beneficiaries — and a warning to practices that downstream providers may also be putting their files in danger.

DEA prescribers should start MATE prep before their next renewal date

08/21/2023

by: Julia Kyles, CPC

Make sure clinicians who prescribe controlled substances complete the eight hours of training required by the Medication Access and Training Expansion (MATE) Act. Effective June 27, all prescribing clinicians who are registered with the Drug Enforcement Administration (DEA) must attest that they completed the training when they renew their registration or apply for the first time.

Make sure SUD training meets MATE’s requirements

08/21/2023

by: Julia Kyles, CPC

Whether your prescribers think they’ve met the MATE Act’s training requirements or they’re looking for a way to meet the training requirement before they renew their DEA license, make sure the substance use disorder (SUD) training is offered by a properly accredited group.

CMS makes a push to activate, pay for ‘caregiver training services’

08/21/2023

by: Richard Scott

You may find fresh billing opportunities when your providers enlist the help of caregivers in a patient’s treatment plan, according to the proposed 2024 Medicare physician fee schedule released July 13. CMS seeks to make active a suite of behavioral management and functional improvement training codes in 2024.

Accurately report JW, JZ modifiers before Oct. 1 enforcement

08/21/2023

by: Laura Evans, CPC

By now, most practices should be aware of the JW and JZ modifiers, which you are to append to codes for single-dose drug containers that you bill to Medicare Part B.

Map out state-level data for AWVs to see where your practice stands

08/21/2023

by: Julia Kyles, CPC

Check your claims for subsequent annual wellness visits (AWV) (G0439) against state level data. You can mine the information to provide a more nuanced picture of your billing data, capture a peek into the services your competitors provide and alert you to coding patterns that warrant a closer look.

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