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Pace of increase in smoking cessation visits slows; denials for visits up

03/28/2016

New CCI edit changes that allow tobacco use counseling services 99406 and 99407 to be reported on the same day as initial observation or inpatient visits without a modifier may boost use of those codes.

New Part B drug pay models intended to boost quality would test providers

03/21/2016

by: Julia Kyles

The agency noted that to gather a robust enough data set and get valid results, they need every provider to participate, Warren says. With the exception of Maryland, the test will randomly sort all primary care service areas (PCSAs, clusters of ZIP codes that reflect the delivery of primary care) into one arm of the test.

Prepare yourself and your staff for law enforcement searches

03/21/2016

by: Roy Edroso

Make sure everyone at your practice knows the drill in the event that law enforcement conducts an impromptu search and seizure of your files.

Value-based modifier cuts, bumps hit practices; focus on 2016 reporting

03/21/2016

by: Richard Scott

The value-based modifier (VBM) program – a ramped-up version of the physician quality reporting system (PQRS) that scales payment to cost and quality measures – sunk its teeth into 59 practices this year, and those practices will see – pay cuts of as much as 2% for the rest of the year.

Hear, hear: 3 tips to successfully report new cerumen-removal code

03/21/2016

by: Richard Scott

The debut of cerumen-removal code 69209 gave practices a new avenue for reimbursement in 2016, but early indicators show you’ll need to pay close attention to the code’s strict reporting protocol, including modifier use, to ensure reimbursement.

Proposed enrollment rule will have practices rethinking relationships

03/21/2016

by: Julia Kyles

What’s the worst thing that could happen to a practice if one of its partners hasn’t refunded an overpayment to the state’s Medicaid program? Under the proposed enrollment rule released Feb. 25, the practice could have its application denied or revoked if it doesn’t report the debt during the enrollment or revalidation process.

Value-based modifier program tallies $79 million in payments, adjustments

03/21/2016

by: Richard Scott

Some practices are reaping 32% gains this year based on their performance in Medicare’s value-based modifier (VBM) program, according to data CMS released in early March

Add 3 key screenings to update your AWV form, secure revenue

03/14/2016

by: Roy Edroso

If you haven’t updated your annual wellness visit (AWV) form since the service first became billable in 2011, you actually don’t have to do too much beyond add some preventive services that can be billed with or initiated as part of the service.

CCI edits: Bill infusions with other services; watch endoscopy code bundles

03/14/2016

by: Richard Scott

You can bill intravenous infusion codes with just about any other service you perform, according to the latest quarterly coding edits from the National Correct Coding Initiative (CCI) released in February.

5 documentation errors that could cost you your home health certification fee

03/14/2016

by: Roy Edroso

Protect your payment for certifying home health services as CMS institutes a sweep of claims by avoiding these five common certification errors.

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