I recently noticed that G0102 is bundled with G0438 in CCI edits. I am confused by this, because I did not understand G0438 to be a physical examination, but rather a wellness visit. In reviewing the requirements of a G0438, there is nothing that would indicate an examination. Do you know why they are now bundled?

Download this month's tool -- a spreadsheet showing time thresholds for base E/M codes and prolonged service codes -- to help you capture extra revenue from time-consuming, counseling-dominated encounters. You can use the time thresholds to determine whether you can bill a prolonged service code (99354-99359) or whether a standalone base E/M code must be billed, based on typical time as defined by CPT.

You can’t afford to sit on claims that were denied due to common mistakes such as forgotten modifiers and wrong diagnosis codes. The best practices are aggressive, turning these around the same day by fixing them over the phone or by quickly firing off a redetermination request. "Fix it right away or appeal right away, so you don’t have a situation where you could be making the same mistake on future claims,” urges Maxine Lewis, CPC, president of Medical Coding & Reimbursement Management in Cincinnati.

Your practice could be missing out on valuable revenue if it’s in-network with the wrong payers. Choosing to add or drop payers will balance your patient load and is essential to keeping your practice busy and your capitalizing profits, experts say.

Here are key signs to watch out for and tips on what to do when evaluating your practice’s current payer networks’ sufficiency:

This chart shows median physician compensation for 20 major specialties, comparing 2008 to 2011 survey data from the American Medical Group Association (AMGA). The average compensation boost across all 20 specialties was $29,888 and the percentage gain was about 9.6% over the three-year period.

Is there a time limit for CMS to recoup overpayments?

Download this month's tool -- a labeled template of a successful appeals letter -- to help you quickly turn around denied claims, especially denials that were caused by simple mistakes. You can use the format of this appeal letter to develop your own variation that accounts for your specific specialty, denials and patient cases.