You can bill subsequent hospital care codes (99231, $30.09 and 99232, $54.22) when the services you provide that would have previously been billed as inpatient consults don't meet criteria for use of the lower-level inpatient hospital care code 99221, CMS states in a newly published 12-page document. Your carriers have begun to update their own instructions based on the CMS guidance.

You've got until Oct. 1, 2012 to get an electronic health records (EHR) system in place that meets the final meaningful use rule CMS will unveil this year. Meet this goal and you're eligible for up to $15,000 in government incentive money - the full amount possible in the first round of EHR bonus payments.

Your claims have been released for processing by CMS after lawmakers delayed the 21% cut to your Medicare payments until April 1.

President Barack Obama signed the Temporary Extension Act of 2010 on March 2 - ensuring you will get paid the same amount for services rendered in March that you got in January and February. The bill also extends the therapy cap, which expired Jan. 1, to March 31.

You and your peers have seen a mixed payment record on the top codes you billed to Medicare over the last three years. This chart shows the top three high-utilization, high-denial codes billed by the four specialties that bill the most codes overall to Medicare. The percentages above the bars show the denial rate for each code in 2008. Data from 2006 is not shown, but will be used as a point of comparison.

If a patient receives an injection during a follow up visit (99211 - 99215), can we bill the injection and also bill the office visit with modifier 25? We were told we can only bill the office visit and the injection for a new patient visit.

Part B News brief

Here are your deadlines for filing claims for services in 2010. As is the case in 2009, you have anywhere between 15 and 26 months to file a claim depending on the month a service was provided (PBN 2/16/09).

Your peers are spending more than a whole day accessing Physician Quality Reporting Initiative (PQRI) feedback reports, according to a Medical Group Management Association (MGMA) study. The MGMA recently surveyed its member satisfaction with the PQRI program. Less than half of survey participants were able to access 2008 PQRI reports made available last fall.

With consultation codes no longer paid by Medicare and some Medicare Advantage plans, your specialty practice is getting less money from every patient sent by primary care doctors. But when you bill only the replacement E/M codes on talk-heavy referral visits, you leave money on the table, experts say.

All four Recovery Audit Contractors (RACs) have asked CMS to expand the maximum caps on the number of medical records that can be requested per provider, per 45-day period, says Connie Leonard, director of CMS's Division of Recovery Audit Operations. This is because the RACs want to perform more complex reviews, which require targeted practices to turn over medical records to the RACs (PBN 4/20/09).