Part B News
Update: E/M pay cut tied to modifier 25 affects only certain payer plans
08/28/2017
by: Richard Scott

Some providers face a fee schedule cut of 50% for E/M services billed with modifier 25 (Significant, separately identifiable E/M service), but you’re in the clear unless you treat patients who carry insurance from Independence Blue Cross or one of its parent company’s other subsidiaries

Annual training is key in meeting the bloodborne pathogen standard
08/28/2017
by: Marla Durben Hirsch
Make sure that your workers have been trained in the Occupational Safety and Health Administration’s (OSHA) compliance requirements, especially now that the penalties for violations have increased.
Proposed physician fee schedule: Payment impact on CVC, PICC and artery lines
08/28/2017

CMS intends to trim relative value units for the following five codes. The chart shows how the changes would impact your payment next year. All fees are national.

Part B News briefs
08/28/2017

AHIMA rolls out a model health record request form; medical biller sentenced to four years for taking cut of physician’s fraud funds;  double-billing doctor pleads guilty to fraud.

Professional services modifier 26 goes down smooth — but watch for outliers
08/28/2017
by: Roy Edroso & Julia Kyles

With a few exceptions, Medicare providers seem to have a pretty good understanding of modifier 26 (Professional services) and see denial rates mostly lower than 10%, though some notable exceptions exist.

Yelp plugs gaps in rating websites
08/28/2017

Websites that provide patient ratings of physicians and hospitals are often criticized for not providing enough clinical information on physicians, but a recent study and blog post suggest the “Yelp” approach to healthcare provider ratings is an effective tool that provides information of interest to consumers.

As compliance costs mount, take advantage of 4 tips for better MIPS reporting
08/21/2017
by: Roy Edroso

A new survey shows practices spending thousands of dollars on their merit-based incentive payment system (MIPS) compliance, but you can cut costs with some pre-planning on reporting method and records prep.

CMS rolls back joint replacement program, jettisons planned episode payment models
08/21/2017
by: Laura Evans, CPC
CMS is preparing to cancel four mandatory episode payment models for common cardiac and orthopedic conditions that were due to begin in January, according to a proposed rule issued Aug. 15.
Watch billing-period rules for new flu vaccine debuting this year
08/21/2017
by: Richard Scott
Take note of a new flu vaccine that’s emerging for the upcoming season and be careful of the fluctuating billing requirements — they’re on track to shift midway through the 2017-2018 flu season.
Watch your enrollment ownership reports as CMS hints at enforcement
08/21/2017
by: Roy Edroso
Check your provider enrollment information to make sure your practice owners are correct or risk revocation of your billing privileges as the Office of Inspector General (OIG) gets tough on enforcement.
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