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CMS holds MIPS eligibility information; check your billings to get a clue

02/12/2018

CMS is late again alerting providers to their eligibility for the merit-based incentive payment system (MIPS), yet the quality reporting period has begun. If you’re on the border of exclusion, run some numbers to see whether it’s worth risking a penalty by assuming you’ll be spared.

Budget bill fixing GPCI floor and therapy cap exception expected to pass

02/12/2018

by: Roy Edroso

The work geographic practice cost indexes (GPCI) floor and therapy cap exception — both of which were allowed to lapse at the end of last year, throwing payments into doubt — are expected to be reinstated by new budget legislation before Congress at press time.

9 ways to avoid the hazards of an OSHA investigation

02/12/2018

by: Marla Durben Hirsch

The change in the White House and lack of an appointed head of the Occupational Safety and Health Administration (OSHA) has apparently not affected the agency’s investigations of health and safety hazards in the workplace, which continue to be robust. OSHA can investigate an alleged violation of its requirements at any time, warns attorney Carla Gunnin with Jackson Lewis in Atlanta. In most instances, the agency will not provide advance notice of an inspection, which entails an opening conference, a walk-through in the employer’s offices and a closing conference.

If the patient leaves the visit early, unless it’s for the ER, it’s no charge

02/12/2018

by: Roy Edroso

Question: We had a patient walk out of an encounter before the doctor could complete her exam. Is there any way to bill for this?

Gastro, ortho specialists report most discontinued, increased procedural services

02/12/2018

by: Richard Scott

When you’re forced to end a procedure early or, alternately, report additional work because of unexpected factors, two little used modifiers – CPT modifiers 53 (Discontinued procedure) and 22 (Increased procedural service) – offer a means to accurately report your efforts.

From the Part B News blog

02/12/2018

by: Richard Scott

Discover the news that happens between Part B News issues by checking out the free Part B News blog. Here's a sampling from this week.

Don’t get caught up in duplicate claims denials; turn to modifiers, resubmit as needed

02/05/2018

by: Richard Scott

Avoid seeing automatic denials on duplicate claims that you may unintentionally file by paying close attention to the nuances of repeat procedures and the modifiers you can report to get your claims successfully out the door.

Does your EHR contract cover a cloud collapse? Ask after Allscripts debacle

02/05/2018

by: Roy Edroso

The failure of Allscripts’ electronic health record (EHR) server, which left about 1,500 providers high and dry for days, serves as a warning that offloading your server-side operations isn’t a foolproof defense against hackers – and that you may find yourself without coverage for days lost by your vendor.

Beware of 3 ABN pitfalls plus answers to 6 key ABN compliance questions

02/05/2018

by: Julia Kyles

Make sure your practice isn’t falling behind on compliance with Medicare’s rules for the advance beneficiary notice of noncoverage (ABN). The ABN process is complicated and continues to trip up practices, warned Maxine Lewis, CMM, CPC, CCS-P, president of Cincinnati-based Medical Coding & Reimbursement.

CMS releases payments exceeding therapy cap despite end of exclusion

02/05/2018

by: Roy Edroso

Providers who submitted therapy claims that exceed the therapy caps and contain modifier KX (Requirements specified in the medical policy have been met) will start seeing their payments after a “rolling hold,” CMS announced Jan. 28.

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