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Be careful when using new G-codes for negative pressure wound therapy

03/18/2013

Check coverage carefully on the new G-codes for negative pressure wound therapy (NPWT). The coverage may extend to more than one kind of device, and you will have to document its use carefully. This year, CMS added two G-codes — G0456 and G0457 — for the use of disposable NPWT devices.

CMS updates 2013 PQRS requirements, start reporting now to avoid 2015 penalty

03/18/2013

by: Lauren C. Williams and Laura Evans

Start reporting measures this year for CMS’ Physician Quality Reporting System (PQRS) program or you won’t be able to avoid a 1.5% pay cut starting in 2015.CMS made several updates in February to the PQRS program reporting requirements, including adding and deleting measures and measure groups, pursuant to the 2013 final physician fee schedule.

Navigate negative patient response to doctor-pharmaceutical relationships

03/18/2013

by: Lauren C. Williams and Marla Durben Hirsch

More need-to-know facts about how the Sunshine rule affects your practice

03/18/2013

by: Marla Durben Hirsch

While non-payer payments from manufacturers and vendors are not inherently illegal or inappropriate, you must tread carefully. Here are four ways the rule will affect your practice:

Providers struggle with high denials for wound care services, 2010–2011

03/18/2013

by: Lauren C. Williams

The following graphs represent how successful providers billed wound care services such as surgical debridement (11042–11047, 97597–97598) and negative pressure wound therapy or wound vacs (97605–97606) in 2010 and 2011.

Pinpoint how, when you notify payers of patient visits to comply with HIPAA

03/18/2013

by: Karen Long

Identify in your practice’s workflow the times when you communicate to insurance companies specific information about a scheduled patient encounter — such as at scheduling or pre-authorization — so you can ensure you comply with a patient’s request to withhold information about a visit or treatment from a payer.

Next issue -- advanced preview: Pinpoint how, when you notify payers to comply with HIPAA

03/12/2013

by: Karen Long

Identify in your practice’s workflow the times when you communicate to insurance companies specific information about a scheduled patient encounter – such as at scheduling or pre-authorization – so you can ensure you comply with a patient’s request to withhold information about a visit or treatment from a payer.

CMS’ bundled care initiative may have work for skilled physician practices

03/07/2013

by: Roy Edroso

Hundreds of hospitals across America are involved in CMS’ Bundled Payments for Care Improvement (BPCI) Initiative. There may be some business in it for your practice – if you have the right skills.

Now that Sunshine Act is finalized, start clocking vendor payments

03/07/2013

by: Lauren C. Williams and Marla Durben Hirsch

Start prepping your practice now to keep its own records of payments and gifts from non-payers, including drug and medical equipment manufacturers, as those entities gear up to report those same payments to HHS in the coming months.

12 Sunshine Act exclusions

03/07/2013

by: Lauren C. Williams and Marla Durben Hirsch

While physicians will have 45 days to contest payments from drug and device manufacturers and vendors before they are posted, your best defense will be to know which aren’t subject to the rule.

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