Summary: This chart compares the denial rates for new and established office visits, levels 3 to 5, by specialty based on the latest CMS claims data from 2009. These specialties were chosen to cover a diverse array of practices. NOTE: Data labels indicate the actual denial rate for the level 3 and level 5, omitting level 4.

This week's question is answered by Regan Bode, CPC, CPC-H, CPMA, CEMC, ACS-EM, content manager for DecisionHealth and consultant for DecisionHealth Professional Services.

Q. It is my understanding you can bill a separate procedure during a non-covered [preventive care service] (99381-99397). Can the additional procedure be a visit such as a 99213? Which codes would get the 25 modifier?

Your non-physician practitioners (NPPs) can play a huge role in helping your practice and patients reap the full benefits of Medicare's new annual wellness visit (AWV), experts tell NPP Report. Not only does the final 2011 Physician Fee Schedule allow NPPs to furnish the annual wellness visit, it also allows them to bill this new service incident to, without the physician needing to be in the same room.

Congressional updates to the 2011 Medicare Physician Fee Schedule will provide a small boost to therapy services when compared to just a month ago. The multiple procedure payment reduction (MPPR) on therapy services has been further weakened and lawmakers elected to bring back the therapy cap exception next year.

This week's question is answered by Regan Bode, CPC, CPC-H, CPMA, CEMC, ACS-EM, content manager for DecisionHealth and consultant for DecisionHealth Professional Services.

Q. Do the surgery global periods apply to the assistant at surgery the same way that they apply to the primary surgeon?

Summary: How does switching to an electronic health record (EHR) system affect the cost of having non-physician practitioners (NPPs) in your office? Few lengthy surveys are available, but this data from the Medical Group Management Association (MGMA) represents some of the most comprehensive so far. Even so, the data is limited to only a few specialty types.

If the physician saw a patient that was in observation status for an E/M visit and performed a kidney biopsy on the same date of service as a result of the visit, will there need to be a modifier? The diagnoses are going to be the same, is that acceptable?

Do practices really see an increase in revenue after changing from paper-based records to an electronic health record (EHR) system? It appears the answer varies significantly based on practice specialty, according to a survey of 1,324 practices nationwide by the Medical Group Management Association (MGMA).

Download the December Tool of the Month to help you determine how your claims stack up against 1995 and 1997 E/M guidelines (see story).

HHS has issued an interim final rule limiting the amount of premium dollars an insurance company can spend on administrative costs - which will mean 80% to 85% must be allocated for patient services starting
in 2011.