Physical therapists from around the country recently received comparative billing reports (CBRs) evaluating use of the modifier KX. The reports compare a provider's KX usage with his or her peers, and are for informational purposes only, says Safeguard Services LLC, a nationwide contractor running the program.

Modifier KX allows providers to bill therapy services for patients who have exceeded Medicare's physical therapy cap of $1,860 or occupational therapy cap of $1,860. Safeguard reviewed 2009 claims from 5,000 providers to see if the modifier was being used properly. The contractor says: "Physical Therapy providers are instructed to use the KX Modifier to indicate that the services that they are rendering are: (1) medically necessary and that justification is documented in the medical records, (2) the physical therapy financial limitation cap has been met, and (3) that the beneficiary's condition is such that they require further treatment."

Read more on modifier KX

One of the most confusing areas of the final meaningful use rule has been a little thing called clinical quality measures (CQMs). Your peers hit CMS again and again with questions on what these are, how many of them must be met, and how they fit into the total number of meaningful use requirements needed to secure up to $40,000 in EHR incentives. Here's how this works, in a nutshell: CQMs are statistics that you report to CMS or, in some cases, to state medical agencies (read more) ...

A remarkable 42.2% of physicians say they've had a medical liability claim filed against them at some point in the career, according to a recent AMA report. More than 20% of physician respondents say they've been sued more than once. There is some good news: About 65% of the claims filed were dropped, dismissed or withdrawn, AMA researchers found. But the bad news is that defense costs are high, with an average cost of defense pegged at $40,649 and the lowest costs hovering around (read more) ...

It's finally begun: CMS's Recovery Audit Contractors (RACs) have started reviewing claims for medical necessity, though at this point only inpatient claims are being targeted. Remember: There are four permanent RACs that have jurisdiction over various regions of the country. Only one of them, CGI Technologies and Solutions, Inc., is targeting medical necessity (also known as "complex" reviews). CGI is the RAC for Region B, which covers Michigan, Minnesota, Illinois, Indiana, Kentucky, Ohio and Wisconsin (read more) ...

The HHS Office of Inspector General estimates POS selection errors triggered more than $13.8 million in overpayments in 2007.