Part B News | Part B News

CMS issues new edits for drug tests, nerve blocks

07/03/2023

Take note if your practice bills presumptive and definitive drug tests. Effective July 1, a new procedure-to-procedure (PTP) edit will bundle definitive drug tests into presumptive drug tests. CMS also set a modifier indicator of 0 for the edit, which means you won’t be able to break the pair with a modifier.

Service increase: How to report a shoulder arthroplasty with modifier 22

07/03/2023

by: Savannah Schmidt

Question: What intraoperative work would warrant reporting a reverse shoulder arthroplasty with physician modifier 22 (Increased procedural service)?

Count MDM risk level based on viable treatment options discussed at encounter

07/03/2023

by: Laura Evans, CPC

Question: When selecting the level of risk to code based on medical decision-making (MDM), the 2023 E/M guidelines state that you can count the risk of treatment options that were discussed but ultimately not chosen. We are wondering how much discussion must be documented in order to count toward risk? For example, our providers will list the treatment options and then document what was recommended and decided...

Physicians score EHR systems highly, but many ding chart time

07/03/2023

by: Julia Kyles, CPC

More than 60% of physicians are “very” or “somewhat” satisfied with their electronic health record (EHR) systems and described documenting clinical care – whether they use a paper or EHR system – as “very” or “somewhat” easy, according to analysis of the last three National EHR Surveys, which contain data for 2018, 2019 and 2021.

Overbooking underperforming? 5 tips to unstick your schedule

06/26/2023

by: Roy Edroso

Overbooking patient encounters is an open secret in practice management. But it can be tricky to get the mix of expected no-shows and available provider slots right. Experts suggest some tech fixes, and also alternatives that may, at least to some extent, make the balancing act easier.

Latest quality payment report hints at registries’ growing popularity

06/26/2023

by: Julia Kyles, CPC

Usage patterns show that providers favor all-in-one electronic methods to submit their quality payment program (QPP) data.

Discover 395 new ICD-10-CM codes taking effect in October, plus revisions, deletions

06/26/2023

by: Julia Kyles, CPC and Laura Evans, CPC

Prepare for several hundred new ICD-10-CM codes now finalized to take effect Oct. 1. On June 16, CMS announced the addition of 395 new diagnosis codes, 25 deletions to the ICD-10-CM code set and 13 revisions. In addition, there are hundreds of changes to tabular instructions added in the addenda for the FY 2024 code set.

SCOTUS False Claims ruling could mean fewer future whistleblowers

06/26/2023

by: Roy Edroso

A recent Supreme Court ruling on the False Claims Act (FCA) argues that the U.S. government can withdraw from a qui tam case even when it has decided not to enter it — which may winnow the number of whistleblower cases going to trial in the future.

Calling patient with test results is not a telephone E/M service

06/26/2023

by: Julia Kyles, CPC

Question: Our physicians and nurse practitioners (NP) prefer to call patients with their test results rather than waiting until the next visit or delegating the task to a member of clinical staff. Most of the calls last at least five minutes, but some can take much longer. Our providers have said we should bill the calls as telephone E/M services (99441-99443) when the patient is a Medicare beneficiary or has a payer that covers telephone E/M. Is that permissible?

Reminder: Modifier KX is the cure for gender-based denials

06/26/2023

by: Julia Kyles, CPC

Practices that treat transgender, intersex, and gender-expansive patients take note: When a gender-specific procedure or diagnosis code doesn’t match the patient’s reported sex, coders should append modifier KX (Requirements specified in the medical policy have been met) to the claim.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.