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Ensure your EHR vendor’s readiness for dual compliance deadlines to avoid delays, penalties

09/19/2013

Find out now whether your electronic health records (EHR) vendor will be ready for ICD-10 and stage 2 meaningful use in 2014, or risk claim submission delays and penalties. Vendors will need to increase their available resources if they plan to roll out ICD-10 and stage 2 meaningful use update software at the same time, experts say.

New RAC issue: Drug screening claims face audit scrutiny

09/19/2013

by: Lauren C.Williams and Laura Evans

Your revenue is at risk if your practice regularly bills urine drug tests thanks to a new recovery auditor (RAC) target. HealthDataInsights, the RAC for Region D — Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming — is going after G0431 (High complexity test) and G0434 (CLIA-waived or moderate-complexity test) for excessive billing. In particular, HDI is concerned with billing the G-codes per drug that is tested.

Benchmark: Percent change in E/M utilization, 2011-2012

09/19/2013

by: Roy Edroso

In recent years, the number of claims with E/M new-patient codes (99201-99205) have been rising — particularly at Level 4 and Level 5, which grew by a whopping 157% and 193%, respectively between 2007 and 2011. Claims with established-patient codes, on the other hand, grew a little at the high end but actually declined for Levels 1, 2 and 3. New CMS data shows a few changes between 2011 and 2012.

Hardship exceptions that waive EHR penalties will be hard to get

09/13/2013

by: Roy Edroso

Don’t count on an exemption from the meaningful use program to get your practice out of up to 5% in Medicare payment cuts. Many of the exception categories, which seem broad, won’t be easy to qualify for, a CMS spokesman suggested in a recent provider call.

Hundreds of changes will affect how you code cardio, GI and ortho procedures

09/13/2013

by: Laura Evans

Physician practices can expect big changes in the CPT codes they report next year for their upper and lower GI endoscopies, breast biopsies, peripheral vascular stents and chemodenervations, among other changes, according to the AMA.

Use financial counseling to improve collections, patient relationships

09/13/2013

by: Roy Edroso

As out-of-pocket costs rise, you can offer financial counseling to not only collect more money from patients, but also improve your relationship with them.

Experts: Payers likely to offer lower rates, reduced access

09/13/2013

by: Scott Kraft

Early signs suggest that contract rates being offered by insurance companies for 2014 — the first year under the Affordable Care Act (ACA) — reflect lower growth than in previous years, experts tell Part B News.

Medicare wants you to use modifier 76 for repeat services on same date

09/13/2013

by: Scott Kraft

A little-noticed policy clarification about how modifiers 59 (Distinct procedural service) and 76 (Repeat service) should be used on claims is causing denial headaches for practices.

First look: 2012 Medicare claims data shows uptick in drug, therapy denials

09/13/2013

by: Lauren C. Williams

Part B News looks at the 100 most frequently billed codes — not including chiropractic, durable medical equipment or lab codes — in 2012 and analyzed 10 codes’ denial rates higher than 10%.

4 tips to update business associate agreements by HIPAA ‘mega-rule’ deadline

09/02/2013

by: Jennifer Clampet

Practices are either going too far or not far enough in their business associate agreements as the Sept. 23 compliance date for the HIPAA “mega-rule” approaches, experts say.

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