Federal officials slightly loosened electronic prescribing requirements you must follow to prescribe narcotics in a final rule effective June 1. In short, you'll need to take four steps to set yourself up to e-prescribe narcotics at your practice, say experts who spoke with Part B News about the new Drug Enforcement Agency (DEA) rule.

Increased efficiency and a new, effective way to communicate with patients were two benefits one OB/GYN in Texas saw when he adopted a patient portal at his practice - economic and practical benefits you can see as well. The physician can't quantify how much he saved or how much extra money his practice has earned, but his practice has continued to grow because of the patient portal and the benefits justify the costs.

You and your peers have been using advance beneficiary notice of non-coverage (ABN) forms less frequently over the last few years, according to a Part B News analysis of the latest available CMS claims data from 2008. The number of all Medicare Part B claims billed with the GA modifier (waiver of liability statement issued, as required by payer policy) fell to a five-year low of about 37.5 million in 2008.

This week's question is answered by Sean Weiss, CPC, vice president, DecisionHealth Professional Services. 

Q. Can non-physician practitioners (NPPs) such as physician assistants (PAs) or nurse practitioners (NPs) have reciprocal billing arrangements with one another if all of the PAs/NPs are enrolled in Medicare?

Summary: Non-physician practitioners (NPPs) are billing more simple dermatology services while utilization among dermatologists and primary care providers is decreasing, according to an NPP Report analysis of CMS claims data from 2006 to 2008, the latest available.

Non-physician practitioners (NPPs) are billing more simple dermatology services such as skin tag removal and basic lesion excision, a sign that physicians want to concentrate on tougher, higher-value dermatology services while using NPPs to fill a growing demand for simple dermatology procedures, experts say. While NPPs generally bill simple dermatology services without a hitch, denial rates have climbed.

The $1 trillion health care reform bill impacts the non-physician practitioners (NPPs) at your practice as well as physicians. A NPP will need to participate in the Physician Quality Reporting Initiative (PQRI) by 2015 or see his or her Medicare payments reduced by 1.5%. By 2016, payments will be reduced by 2% when an NPP fails to report PQRI measures. 

This week's question is answered by Sean Weiss, CPC, vice president of DecisionHealth Professional Services.

Q. A follow-up to last week's Ask a Part B News Expert (PBN 4/19/10) - Here's the trickier scenario that comes up: When Dr. A decides to leave his current practice and join Dr. B., one of Dr. A.'s patients decides to follow him to the new practice. A month later the patient has an immediate medical need but her first encounter at the new practice is with Dr. B. Will Dr. B. bill a new or established visit code?

You can get reimbursed for services provided to prison or jail inmates on Medicare under certain circumstances, according to a recent CMS transmittal. CMS uses data from the Social Security Administration to determine when a patient is behind bars. In most cases, Medicare will deny claims for patients in the big house, but here's a few conditions when the program will provide coverage.

Summary: Allergy and oncology services have seen some of the greatest percent growth in denial rates from 2006 to 2008, while psychiatry codes are among the services on the opposite end of the spectrum. NOTE: This chart measures the percent change in the denial rate - itself measured by a percent figure - of the highest-utilization codes from 2006 to 2008. Services billed less than 1 million times annually to Medicare were excluded from analysis, as were all pathology and laboratory test codes.