Part B News
01/06/2017

At least two U.S. states are considering laws that would modify Maintenance of Certification (MOC) requirements for physicians and prohibit hospitals and insurers from making them a condition of hospital privileges or reimbursement, following the lead of a law in Oklahoma that went into effect in November 2016.

01/02/2017
You’re eligible to provide a health risk assessment (HRA) to patients and caregivers using two new CPT codes starting Jan. 1, while previous HRA code 99420 hits the trash heap.
01/02/2017

The new year has the possibility of being a time of unprecedented change in health care. Here’s how Part B News expects physician practices to be affected.

01/02/2017

Check out how Part B News and its experts fared with the 2016 predictions:

01/02/2017

CMS rolled out a final rule Dec. 20 outlining three new cardiac care models and one new orthopedic care model to start as early as July 1 as well as one new small-practice-friendly accountable care organization (ACO) track to start in 2018.

01/02/2017

Question: A patient of a multispecialty group practice came in to see an internist. She reported herself pregnant — though this had not been medically confirmed... a few weeks later, the pregnancy was confirmed on a visit to our OB... Can the practice use the pregnancy O codes on the first visit, even though they plan to bill the confirmation code Z32.01 for the later ob/gyn visit?

01/02/2017

Question: Medicare denied 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]) when our ambulatory surgery center reported it with 20610 (Arthrocentesis, aspiration and/or injection, major joint or bursa [e.g., shoulder, hip, knee, subacromial bursa]; without ultrasound guidance). Can you explain why we’re getting this denial?

01/02/2017

The competition for a limited amount of incentive dollars tied to the merit-based incentive payment system (MIPS) may be fierce in 2017, as nearly two in five respondents to a recent medical practice survey said they would report multiple measures during the 2017 transition year.

01/01/2017
by: Centers for Medicare & Medicaid Services
National Correct Coding Initiative Policy Manual for Medicare Services
Revision Date: 1/1/2017
01/01/2017
by: Centers for Medicare & Medicaid Services
Introduction
On December 19, 1989, the Omnibus Budget Reconciliation Act of 1989 (P.L. 101-239) was enacted. Section 6102 of P.L. 101-239 amended Title XVIII of the Social Security Act (the Act) by adding a new section 1848, “Payment for Physicians' Services”. This section of the Act provided for replacing the previous reasonable charge mechanism of actual, customary, and prevailing charges with a resource-based relative value scale (RBRVS) fee schedule that began in 1992.

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