Part B News | Part B News

Feds’ data analysis of doctor’s prescription pattern leads to guilty plea

04/13/2015

Don’t think your physicians’ billing activity is too small to be noticed. A new case demonstrates that the government’s radar can go more deeply into the weeds than ever.

OIG ramps up meaningful use audits on top of CMS’ audit efforts

04/13/2015

by: Marla Durben Hirsch

If you thought practices couldn’t be audited any more than they already are, brace yourself: HHS’ Office of Inspector General (OIG) has begun to audit physicians’ compliance with the meaningful use electronic health record (EHR) incentive program.

‘Floor time’ allowable when documenting time for inpatient E/M services

04/13/2015

by: Scott Kraft

Make sure that face-to-face time spent counseling the patient or coordinating care dominates the total service time when you’re also counting “floor time” in the hospital toward an E/M visit.

Pre-op work-up on screening colonoscopy not billable — unless something changes

04/13/2015

by: Roy Edroso

Question: Is the E/M service on a screening colonoscopy billable?

Drug price changes show 101.9% higher payments for albuterol

04/13/2015

by: Scott Kraft

About a handful more drugs saw their Medicare prices increase April 1 compared with those that decreased, according to a Part B News analysis of drug price changes under Medicare’s payment formula, which uses the average sales price (ASP) plus 6%.

As Senate action on SGR repeal looms, get your practice through the interim period

04/06/2015

by: Richard Scott

You can expect big changes to your reimbursement and reporting policy should the Senate pass the “SGR repeal” bill upon its return to chambers on April 13, but for now, you’ll want to keep submitting your Part B charges without change or hold them until there’s a resolution to the 21% cut that rolled in April 1.

Prepare to withstand ICD-10 cash-flow disruptions with line-of-credit lifeline

04/06/2015

by: Julia Kyles

Avoid the pitfalls of taking out a loan by obtaining a line of credit to stay afloat during the potentially turbulent period after the transition to the ICD-10 code set Oct. 1.

Rethink how you’ll get patients to engage with your EHR as stage 3 approaches

04/06/2015

by: Roy Edroso

Start questioning your electronic health records (EHR) vendor and your patients about their use of health apps in preparation for bold new meaningful use requirements that could wind up making your compliance easier.

Determine whether provider did expanded problem-focused or detailed exam

04/06/2015

by: Scott Kraft

A piece of the 1997 E/M Documentation Guidelines could help you determine the difference between an expanded problem-focused exam and a detailed exam, even if you’re using the 1995 version.

CBA modifiers may apply to DME billing even if you’re not a contract supplier

04/06/2015

by: Roy Edroso

Question: I keep getting a denial from Medicare on E0143 (Walker, folding, wheeled, adjustable or fixed height). I have used the modifiers KX (Requirements specified in the medical policy have been met) and NU (New equipment), then just KX, then just NU. What am I doing wrong?

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