Part B News | Ask a Part B News Expert

Remind surgeons that NCCI rules for post-op pain management still apply

04/06/2026

Question: I work for a group of surgeons that wants to start billing for post-operative pain blocks. For example, a transversus abdominis plane block (64486-64489) for hernia repair or an intercostal block (64420-64421) for post-mastectomy pain. In the past they’ve asked the anesthesiologist to perform the service, but they claim that they can bill Medicare under a new rule designed to reduce the use of prescription opioids to manage post-operative pain. Is that correct?

There’s more to high risk than the examples in the E/M guidelines

03/16/2026

by: Julia Kyles, CPC

Question: For the purposes of E/M coding, does intravenous (IV) contrast for diagnostic imaging fit the definition of “Drug therapy requiring intensive monitoring for toxicity” under the high-risk section of the medical decision-making (MDM) table’s “Risk of complications and/or morbidity or mortality of patient management”?

How to report multiple sclerosis medication administration

03/16/2026

by: HCPro staff

Question: How do you code medication administration for a patient with multiple sclerosis?

Subletting a doctor’s office? Make sure you’re covered, not coasting

03/02/2026

by: Roy Edroso

Question: I saw a recent article in the New York Times that discussed, among other things, physicians subletting their or other doctors’ offices. The story had a real estate focus, though, and didn’t get into the legal and regulatory requirements for physicians who do this. What should prospective sublessees be thinking about?

Know when add-on behavioral codes apply to the APCM code set

02/16/2026

by: HCPro staff

Question: How has the 2026 Medicare physician fee schedule final rule, effective Jan. 1, 2026, affected coding of advanced primary care management (APCM)?

More certainty required: A possible threat doesn’t meet critical care definition

01/19/2026

by: Julia Kyles, CPC

Question: Would a possible threat to a limb meet the requirement for a critical care service?

When ADRs appear, ensure timely responses, go electronic

01/12/2026

by: HCPro staff

Question: Why is it important to respond to additional documentation requests (ADR) in a timely manner?

Overdose coding: What to know when choosing the right diagnosis

12/22/2025

by: Son Hoang

Question: What is the difference between intentional and unintentional overdoses?

Tylenol accusations are thin, but be safe and mention to patients anyway

11/10/2025

by: Roy Edroso

Question: Recently HHS made some frightening accusations about Tylenol and pregnant women, and the Texas Attorney General has brought suit against the makers of Tylenol for “deceptively marketing Tylenol to pregnant mothers.” My question is: Can our doctors get into trouble now for recommending or prescribing Tylenol?

See why it’s vital to capture history and exam during E/M encounters

08/25/2025

by: HCPro staff

Question: What role do the history and exam play in determining the level of an evaluation and management (E/M) service? Are they optional?

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