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2015 isn’t over if you’re submitting PQRS data

01/18/2016

Don’t let up on your 2015 quality reporting efforts yet. To avoid quality reporting penalties in 2017 — and to have a shot at the value-based bonus — you have to get all of your data to CMS on time.

Tell gun-toting patients that new HIPAA gun rule isn’t about them

01/18/2016

by: Roy Edroso

Be prepared to explain to your concerned patients that President Barack Obama’s recent executive order on HIPAA and the national gun database — and the HHS final rule that came with it — will have no affect on you or them.

CMS adds regions for HPSA bonus payment; HRSA announces funding

01/18/2016

You have a greater chance for a Medicare payment bonus if you practice in a region that’s medically underserved now that CMS added 42 ZIP codes to its health professional shortage area (HPSA) program in 2016.

Good omen for PT: Denial rates inch down on top-used codes

01/18/2016

by: Roy Edroso

The Office of Inspector General (OIG) again has focused its attention to “high use of outpatient physical therapy services” by independent physical therapists in its Work Plan — but unlike a few years ago, denial rates for their most-used codes have gone down.

6 compliance trends likely to affect your practice in 2016

01/11/2016

by: Marla Durben Hirsch

Your practice faces several compliance challenges this year, with a greater likelihood that you’ll be slammed with enforcement actions on several fronts. Here’s a rundown of what our experts predict you can expect in 2016.

Review DMEPOS documentation rules as CMS plans preauthorization list

01/11/2016

by: Roy Edroso

The release of a DMEPOS (durable medical equipment, prosthetics, orthotics and supplies) final rule on Dec. 29 makes it even more important to provide all the required documentation to assure your patients get their prescribed medical equipment.

CCI: Don’t bill E/M and CPAP together; use ACP in the hospital

01/11/2016

by: Richard Scott

Don’t report positive pressure therapy code 94660 with an E/M service because those codes are bundled, and watch out for other code pairs that CMS updated with the Correct Coding Initiative (CCI) version 22.0 edits.

Case No. 4: The case of incorrect carrier payments

01/11/2016

by: Maureen West McCarthy, CPA

Discover strategies to overcome incorrect carrier payments through this case study, replete with practical guidance.

When handling workers’ comp cases, make sure to have a payment backup

01/11/2016

by: Roy Edroso

Question: Our patient had a work injury claim for which he needed timely surgery. A workers’ compensation claim was submitted, but we've encountered insurance issue. Can we hold the patient responsible for the bill or at least a portion of it?

Review rules for home visits as OIG focuses on these E/M codes

01/11/2016

by: Julia Kyles, CPC-A

Home visits have caught the eye of the HHS Office of Inspector General (OIG) and landed on the OIG’s 2016 Work Plan. Providers who report these services may receive record requests sometime this year.

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