Last-minute changes to the Obamacare replacement bill, a huge budget cut for HHS and a three-month delay of new episode payment models (EPMs) are among the top health care stories from Washington.

Despite a lack of recent official guidance on the X modifiers that were developed to provide more specifics than modifier 59 (Distinct procedural service), in some cases Medicare providers have seen lower denial rates using the new modifiers, according to CMS data obtained by Part B News.

Give providers an extra dose of billing and coding compliance when it comes to prolonged services by reminding them that Correct Coding Initiative (CCI) rules bar them from reporting certain services for the same patient on the same day. For example, the codes in the chart below may not be reported with prolonged service visits 99354-99355.

You may not find the X-factor you need for getting your claims through with CMS’ quartet of X modifiers if new reporting numbers from Medicare tell us anything. However, in some cases you’ll find extra motivation – read: lower denial rates – to get more X modifiers on your radar.

Question: What’s the best pricing policy for uninsured patients?

The number of solo and small practices continues to dwindle in the U.S., and the pace of consolidation is expected to quicken in the next few years as uncertainty and change continue to pressure independent practices. A number of factors are impacting the bottom line of small practices and physicians, including the high cost of medical malpractice insurance, the demands of health information technology, flat reimbursement rates from Medicare and Medicaid, and the potential for those flat rates to be reduced if a practice doesn’t meet quality reporting benchmarks.