Part B News | Part B News

Looming form changes mark a good time to review ABN rules

04/27/2026

The deadline for a switch to new advance beneficiary notice forms (ABN) is coming. It’s a good time to review the do’s and don’ts for these often-misunderstood forms.

Protect revenue, ensure patient eligibility access update in HETS

04/27/2026

by: Julia Kyles, CPC

If your practice relies on software, a billing company or other third-party vendor to perform patient eligibility checks, you’ll hit a revenue roadblock if you don’t enroll those vendors in the HIPAA Eligibility Transaction System (HETS) by May 11, experts warn.

First entrants in ACCESS tech-assist program announced

04/27/2026

by: Roy Edroso

Just three months after announcing its Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model, designed to pair tech-enabled partners with Medicare providers and pay them based on medical outcomes, CMS has revealed the first 150 partners accepted to participate.

Broad expansion proposed for sepsis ICD-10-CM coding

04/27/2026

by: HCPro staff

At the public ICD-10-CM Coordination and Maintenance Committee Meeting held March 17-18, CDC’s National Center for Health Statistics (NCHS) discussed a draft proposal involving a broad expansion of sepsis diagnosis coding.

ICD-10-CM updates: How to code for patients with diabetes in remission

04/27/2026

by: HCPro staff

Question: Can you explain when it is appropriate to use the recently added ICD-10-CM code for diabetes in remission?

Kidney procedure leaps to top of modifier 78 list

04/27/2026

by: Roy Edroso

After a period of decline, use of the modifier 78 (Unplanned return to the operating room by the same physician following initial procedure for a related procedure during the postoperative period) rose in 2023. It jumped again in 2024 — led by a previously absent code.

Get a glimpse of 180-plus new ICD-10-CM codes set to take effect Oct. 1

04/20/2026

by: Laura Evans, CPC and Julia Kyles, CPC

Proposed changes to the ICD-10-CM code set include new codes for ectopic pregnancy, vanishing twin syndrome, cardiomyopathy, osteomyelitis, numerous toxic effect codes and personal history of Clostridioides difficile infection, among others.

Make cases airtight to protect foreign-born providers hit by visa renewal pause

04/20/2026

by: Roy Edroso

With a “pause” on visa renewals in effect, some foreign-born providers who have been working in the United States find themselves denied renewal and even seized by immigration officials. If you employ such providers and want to keep them, there are some warnings you should pass on to them, and ways to possibly help spare them from being caught up in the crackdown.

Remind providers to document their active participation in incident-to services

04/20/2026

by: Julia Kyles, CPC

Question: An auditor from our Medicare administrative contractor recently informed our practice that to bill services incident-to, the supervising physician must actively participate in the patient’s care, which means seeing the patient every 12 months. Is that what active participation means?

Among most-billed codes, modifier XS tops 59 again in denials

04/20/2026

by: Richard Scott

Once again, medical practices that turned to modifier XS (Separate structure, a service that is distinct because it was performed on a separate organ/structure) in place of modifier 59 returned favorable denial rates on a number of codes that appear on both of the modifiers’ top 10 lists.

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.