Part B News
EHR upgrades are pain point for rev cycle execs, new survey shows
12/31/2018
by: Alexandra Wilson Pecci
The struggle to keep up with electronic health record (EHR) upgrades is an area of concern for revenue cycle professionals, finds a Navigant/Healthcare Financial Management Association analysis.
Watch for upcoming HHS agenda items that may mean changes for HIPAA
12/31/2018
by: Heidi Samuelson
HHS’ semiannual agenda, published in October, included a request for information (RFI) on provisions of HIPAA that may be stalling progress toward increasing coordinated care and case management among hospitals, physicians, payers and patients, and impeding the transformation to value-based payment systems.
Note from the instructor: How to perform a technical evaluation of denials
12/31/2018
by: Linda M. Huckin, RN BSN, ACM, CPC, CDEO, CIC
A denial represents the health care insurance company’s decision not to adjudicate the claim because of a conflict over service, payment or coverage. Starting from this perspective, the appeal strategy must begin with identifying the payer. Next, determine whether the health care insurance is classified and managed as a commercial or government payer and whether the provider’s organization is a contracted or non-contracted entity.
How to effectively document and bill chronic care management
12/31/2018
by: Nena Scott, MSEd, RHIA, CCS, CCS-P, CCDS
Within the past two years, Medicare began issuing a separate payment for chronic care management (CCM) services under CPT code 99490. In 2017, CMS issued new guidelines to provide greater specifications and updated details to improve CCM documentation and billing. This article provides guidance on correct coding, billing and documentation for chronic care conditions in health care as defined by CMS and effective in 2018.
Get definite about definitive drug tests to avoid the attention of auditors
12/31/2018
by: Julia Kyles, CPC
Practices that report definitive drug tests continue to struggle with high denial rates, the latest Medicare Part B billing data for the tests shows. Because CMS has worked to curb improper reporting of the services, continued high denials may trigger audits and other intrusive measures. If investigators get involved, they could use strong-arm methods to wring large settlements out of practices.
Correct Coding Initiative (CCI) version 25.0 scorecard: Code pairs abound
12/17/2018
by: Richard Scott
Alert your billing staff that new code bundles are coming in 2019. You'll find tens of thousands of new code pairs, as well as many deleted pairs and updated medically unlikely edits (MUEs), as part of the latest quarterly update from the Correct Coding Initiative (CCI). The version 25.0 edits take effect Jan. 1.
Computers that learn, an IoT riot, other tech trends coming to practices soon
12/17/2018
by: Roy Edroso

Medical tech innovations are much in the news these days. While many of these seem like distant, pie-in-the-sky ideas, experts tell Part B News you can expect see some widely used in practices over the next few years.

Coming CCI edits bundle E/M services, reduce allowable lesion-removal units
12/17/2018
by: Richard Scott
You soon will welcome more than 45,000 new code bundles that place some level of restriction on your claims reporting — including common debridement, biopsy and E/M services — as the latest Correct Coding Initiative (CCI) edits sweep into place Jan. 1.
Tune up your coding to reap rewards in expanding CCM universe
12/17/2018
by: Richard Scott

As the spectrum of chronic care management (CCM) services widens, avoid a series of common coding and documentation errors, such as missing notes and a lack of specified timing, to ensure your claims are passing through without a problem.

Lesion-removal, skin codes top list of most-used services facing unit cuts
12/17/2018
by: Richard Scott

Among a raft of codes that are on track to lose eligible service amounts in the new year, you’ll find a series of lesion-removal services and other integumentary procedural codes, according to the Correct Coding Initiative (CCI) version 25.0 edits taking effect Jan. 1

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