Part B News | Part B News

Help me help you: Approach hospitals to improve coordination, bill new TCM codes

12/17/2012

Seize your nearby hospital’s attention by promoting your practice as the solution to preventing readmissions. You’ll improve your chances at billing new transitional care management (TCM) codes in 2013 while helping hospitals avoid a penalty that will climb to up to 3% of Medicare payments in two years.

Keep earned revenue, avoid denials with regular EHR-user audits

12/17/2012

by: Lauren C. Williams

Reduce payer audit risk and denials related to faulty documentation in your electronic health records (EHR) with regular audits that check who entered patient information, whether notes are unique and whether errors have been corrected.

Benchmark of the Week: Initial patient upper-level E/M denial rates by specialty

12/17/2012

by: Ben Penn

These charts show initial patient upper-level E/M denial rates from 2010 and 2011, organized by the 12 specialties that bill initial patient E/M office visits most frequently. Based on a Part B News analysis of the latest Medicare claims data available, 99205 denial rates from 2010 and 2011 for each specialty are displayed in the top chart and 99204 denial rates for those years are in the bottom chart.

Correction

12/17/2012

Temporary SGR fix likely between Christmas and New Year’s, lobbyists say

12/10/2012

by: Ben Penn

Your Medicare rates are almost certainly safe from a 26.5% sustainable growth rate (SGR) cut set to take effect Jan. 1. Just don’t expect Congress to reach an agreement on a fix before the very last week of 2012, healthcare lobbyists tell Part B News.

Don’t return your meaningful use check; gather supporting documentation now

12/10/2012

by: Ben Penn

Secure your meaningful use incentive payments by carefully maintaining supporting documentation that proves all the measures you attested for through electronic health records (EHR) were reported accurately to CMS. Or you may have to return your hard-earned meaningful use check.

ALJ hearings will remain a good appeals option, OIG report notwithstanding

12/10/2012

by: Tina Irgang

Providers could soon lose a powerful ally in CMS’ appeals process. A new report from the HHS Office of Inspector General (OIG) means you likely will see CMS and its contractors participate more actively in administrative law judge (ALJ) hearings in an attempt to uphold denials.

Document time estimates, patient specifics to secure 99239 reimbursement

12/10/2012

by: Karen Long

Direct providers to document at least an estimate of how long it took to discharge a patient to support billing 99239 (Hospital discharge day management, more than 30 minutes) and avoid losing $33 per claim.

Benchmark of the Week: Discharge management denial rates, 99238-99239

12/10/2012

by: Ben Penn

This chart displays the hospital discharge management codes’ denial rates for the 18 physician specialties that used the codes most frequently in 2011. Based on a Part B News analysis of the latest Medicare claims data, the denial rates for both 99238 (30 minutes or less) and 99239 (More than 30 minutes) are presented for each specialty, presented below in alphabetical order.

Final 2013 Physician Fee Schedule: Estimated impact on allowed charges by specialty

12/10/2012

See how CMS' relative value unit (RVU) changes will affect your specialty in its 2013 Medicare physician fee schedule final rule.

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