Don’t let a common misconception about Physician Quality Reporting System (PQRS) submission requirements submarine your year-end data reporting, which could leave you on the hook for big penalties in the years to come.

While you may find CMS’ new accountable care organization (ACO) model is too tough for your practice, you should pay attention to this “Next Generation” model anyway because it points to a pay-for-performance future for all Medicare providers.

Be careful when you routinely bill an E/M service along with an injection done during the same encounter. E/M services are typically bundled into most injection codes, and you need to establish separate medical necessity to support billing the E/M service.

Don’t forget to revise your billing system and remind staff to watch for reporting limits on services and supplies, such as fluid drainage and tendon sheath injections, that were added to the medically unlikely file that goes into effect April 1. 

Don’t ignore the edit update that goes into effect April 1 just because it contains only 1,106 new pairs. The edits may impact the way you report the new joint injection codes, among other changes.

Providers on average saw a 17.3% jump in pay per claim for injections of medium joints (20605) in 2013 over the previous year.

When performing a select number of allergy tests, you will get paid for assessing the nitric oxide levels of your patients with a history of a respiratory disorder, which brings an additional $19.67 (Medicare participating, national average) into your practice each time the test is delivered.