Take a close look at the documentation guidelines that CMS suggests for the practice improvement portion of the merit-based incentive payment system (MIPS) and you may ward off future audits and avoid having to forfeit revenue.

Take note of the latest health policy updates impacting physician practices from Washington, D.C.

Question: Our patient had a mastectomy and developed a seroma in the post-operative period. We performed drainage of the seroma in the doctor’s office. Can we bill with modifier 78 (Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period)?

Modifier 78 (Unplanned return to the operating/procedure room by the same physician) is a tough one to get accepted by Medicare contractors. In fact, an analysis of the most recent Medicare data available shows the aggregate denial rate for codes with 78 was 27%. But some codes do much better with it than others.

We upgraded the Part B News listserv to the new Medical Practice Revenue Cycle Forum!

Lawmakers in a half-dozen states are considering bills that would expand the scope of practice for nurse practitioners (NP) and physician assistants (PA) and allow them to practice without physician supervision.

A new study suggests that care provided by nurse practitioners (NP) and physician assistants (PA) for low-acuity ailments is comparable to the care provided by physicians for the same health issues.