Part B News
As younger doctors head for the exits, use job-sharing, other perks to slow attrition
10/29/2018
by: Roy Edroso
As burnout takes its toll, you may find providers — including those under traditional retirement age — leaving more quickly than you anticipated. Take steps now to smooth their transition and reduce the impact to your patients and your practice’s bottom line.
Catch rising wave of Medicare Advantage plans, get boost into value-based care
10/29/2018
by: Roy Edroso
The rise in Medicare Advantage plans offers practices a way to build not only their patient populations but also their pay-for-performance skills, experts say.
4 steps to create denial avoidance programs for coding, documentation
10/29/2018
by: Lynette Kramer, MA, RHIA
Direct your coding and documentation teams to take the same approach as leading practice denial-management programs to not only improve the way they manage and resolve existing denials but also to correct process deficiencies to prevent new denials.
KFF: 99% of Medicare beneficiaries can get Medicare Advantage coverage
10/29/2018
by: Roy Edroso
The growth in Medicare Advantage plans is impressive, but the penetration of those plans into heretofore underserved areas may be even more so, on the evidence of the Kaiser Family Foundation’s recent issue brief “Medicare Advantage 2019 Spotlight: First Look” by Gretchen Jacobson, Anthony Damico and Tricia Neuman.
Navigate AWVs versus physical exams; 4 tips to boost your AWV reporting
10/22/2018
by: Richard Scott
When a Medicare patient calls to request a routine physical, make sure your office is ready to pivot to – and communicate about – an annual wellness visit (AWV). Doing so will add dollars to your practice and insulate you from the threat of patients receiving non-covered services.
Protect PHI when it moves to and from business associates
10/22/2018
by: Marla Durben Hirsch

The recent settlement agreement between the HHS Office for Civil Rights (OCR) and the now-shuttered medical records storage company FileFax Inc. is a good reminder that providers and business associates need to comply with HIPAA and protect PHI not only when they possess or store it but also when they transmit it to each other.

New guidance on LCD requests make process more transparent – but success no more likely
10/22/2018
by: Roy Edroso

CMS has made what looks like large changes to the local coverage determination (LCD) process — but experts don’t think it will make it easier to get an inconvenient LCD changed.

Ordering tests can up the level of medical decision-making, even pending results
10/22/2018
by: Richard Scott

Question: A nurse practitioner told a patient to return after an office visit if his chest pain worsened, and the provider ordered a nuclear stress test to take place the next day. Can my provider count the plan for the stress test in the medical decision-making for the previous encounter, even if the diagnosis isn’t made until eight days after the face-to-face encounter?

Watch CCI bundles, edits for pulmonary function code and E/M services
10/22/2018
by: Richard Scott

Question: All of a sudden, I am getting denials from everyone for billing 99214-25 with 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device). Guidelines say billing the codes together is appropriate unless there is a recent change. Is anyone else seeing denials? Before this month, my claims were going through fine.

Use new Q code for Zilretta injection but watch for payer limitations
10/22/2018
by: Laura Evans

Question: What do you know about payments for Zilretta injections? Anything specific that we need to know about billing?

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