Part B News | Benchmark of the Week

Interprofessional consults slow to lift, but fees can pad your revenue

04/12/2021

Medical practices showed a tepid response to the launch of a series of interprofessional consultations in 2019, the first year that CMS approved the codes for reimbursement.

Interrupted-service modifiers work great with some codes – but wipe out with others

04/05/2021

by: Roy Edroso

It may not be the high overall denial rates that best explain why the two interrupted-service modifiers, 52 (Reduced services) and 53 (Discontinued procedure), are so tricky; it could have something to do with the mix of codes that seldom, if ever, get denied with the modifiers, and those that get rejected most or all of the time.

Vaccine admin payment rates remain down after cuts; COVID aims higher

03/29/2021

by: Richard Scott

Payment cuts to a series of immunization administration codes have significantly curtailed provider payments in recent years, as Medicare slashed rates for the G0008-G0010 series related to influenza, pneumococcal and hepatitis B vaccines.

ACP numbers surge, yet add-on code remains problematic for many

03/22/2021

by: Roy Edroso

Practices accelerated their use of advance care planning codes 99497 and 99498 in 2019, as more providers held – and billed for – important late-life planning sessions with patients.

More Levels 4 and 5 office visits fuel payment gains, despite fewer E/Ms overall

03/15/2021

by: Richard Scott

While the total number of established E/M office visit claims (99211-99215) decreased in recent years, providers still netted a payment increase because of a continued use of Levels 4 and 5 codes.

Subsequent AWV code surges over 3-year period; NPPs advance fastest

03/08/2021

by: Roy Edroso

While the volume of Welcome to Medicare visits has grown modestly and initial annual wellness visits (AWVs) have declined in recent years, the use of subsequent AWV claims has surged at a 26% growth rate.

Remote monitoring codes, new in the billing arsenal, flash revenue upside

03/01/2021

by: Richard Scott

Providers are taking a cautious jump into a suite of remote monitoring and virtual evaluation services that Medicare has approved for use in recent years, but the early returns reveal significant revenue possibilities.

X modifier use skyrockets, and denial rate drops for the 59 replacement

02/22/2021

by: Roy Edroso

Despite the fact that the four X modifiers still don’t have a totally defined role as an alternative to modifier 59 (Distinct procedural service), their utilization continues to expand. A drop in denial rates shows that they may be worth rolling the dice on.

Imaging services net $3.7B for practices, but watch for the spine X-rays

02/15/2021

by: Richard Scott

You may want to inspect your spinal X-rays a tad more closely: Of the most-reported imaging services performed in place of service 11 (Office), code 72100 (Radiologic examination, spine, lumbosacral; 2 or 3 views) fares the worst, with a denial rate over 13%.

Practices improve modifier 25 use; NP, PA activity surges

02/08/2021

by: Roy Edroso

Good news: Denial rates on codes claimed with modifier 25 (Significant, separately identifiable E/M service) remained low among the top 15 code combinations that practices submitted millions of times.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.