Part B News | Benchmark of the Week

Providers favor standalone psychotherapy codes, and the longer the better

10/21/2019

When reporting a series of oft-used psychotherapy services (90832-90838), providers tend to stick to a pattern of long-duration standalone codes and shorter-duration add-on codes.

Chronic care management spike: CPT code 99489 goes up, up and away

10/14/2019

by: Jim Dresbach

The utilization of complex chronic care management (CCM) code 99489 increased more than 285% between 2017 and 2018, as practices appeared to embrace longer-lasting care management episodes.

Outpatient E/M use — especially 99214 — continued to rise in 2018

10/07/2019

by: Roy Edroso

Medicare has published its 2018 patient claims data, which shows a pretty smooth rise in spending for total claims — and a bit of a spike for established patient office E/M code 99214.

A tale of two sides: Practices report more right- than left-side modifiers

09/30/2019

by: Richard Scott

When delivering common injection and procedure services, providers tend to veer to the right side of the body more often than the left. That’s what an inspection of claims with RT (Right side) and LT (Left side) modifiers reveals.

A tale of two sides: Practices report more right- than left-side modifiers

09/30/2019

by: Richard Scott

Not worth it: Codes wrongly bundled with blood draws pay too well to trifle with

09/23/2019

by: Roy Edroso

Auditors emphasize the amount of improper payments attributed to common venipuncture code 36415 with bundled codes in 2018. But it’s also worth noting that the codes with which 36415 may have been improperly claimed generally pay more — and it’s really not worth potentially gumming up your claims on those codes for a small extra payment on a blood draw.

Quarterly CCI update bundles numerous orthopedic procedures with allograft services

09/16/2019

by: Richard Scott with additional reporting by Roy Edroso

Alert your billing staff to several dozen code bundles that will restrict a range of same-day services, including some allograft procedures, when the latest Correct Coding Initiative (CCI) edits take effect Oct. 1.

Coming cataract fees on track to drain millions from payment stream

08/26/2019

by: Richard Scott

Practices are expecting to take a hit on cataract surgery fees in 2020 based on pay rates announced in the proposed 2020 Medicare physician fee schedule, and that could lead to a drain of hundreds of millions of dollars nationally.

Codes cleared with TCM in PFS have nowhere to go but up

08/19/2019

by: Roy Edroso

If the codes CMS just cleared to be billed with transitional care management (TCM) in 2020 see a lift in utilization, you can be pretty confident that clearance will be the reason for the change. That's because, as you can see by this chart, utilization of these codes over the past five years has been very consistent — and mostly low — even when payment terms have been altered.

Money in motion: The top 10 winners and losers from 2020 proposed rates

08/12/2019

by: Richard Scott

Cue the drum roll: After analyzing the numbers and poring over the inputs, a Part B News analysis turned up some big winners and unfortunate losers from the proposed 2020 Medicare physician fee schedule.

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