Part B News
Fewer claims billed but more denials for initial AWVs in 2013 than 2011, 2012
12/15/2014
by: Karen Long
The number of initial annual wellness visits (AWVs) billed by practices dropped from almost 2.2 million when the code was introduced in 2011 to 1.5 million in 2013, the latest Medicare data show. But denials for the service (G0438) increased from 10.7% in 2011 to 20.1% in 2013, the data show.
 
CPT officials, CMS clarify CCM billing, E/M documentation, other 2015 changes
12/08/2014
by: Laura Evans

For the new monthly chronic care management (CCM) services, practices should bill the claim on “the last day of the calendar month for which the CCM service is billed,” according to a senior CMS official.

 
Target 6 documentation areas for transitional care services to avoid denials
12/08/2014
by: Richard Scott

When billing one of the two transitional care management (TCM) codes, stave off denials by ensuring proper documentation of medication reconciliation and key dates within the 30-day service window.

 
CMS rule proposes new ‘track’ to push more ACOs into risk-reward model
12/08/2014
by: Roy Edroso

A proposed new “track” for accountable care organizations offers more revenue potential for participants in the shared-savings program.

 
Treat new patients then keep them with your practice with a flu shot drive
12/08/2014
by: Roy Edrosor

Though you can’t expect much profit from it, you should take advantage of the season to reach out to new patients with a flu shot program.

 
Ensure proper support for claims with modifier 24 as scrutiny ramps up
12/08/2014
by: Roy Edroso
Take extra time to review claims with modifier 24 before billing them after a Medicare administrative contractor’s (MAC’s) probe showed high denial rates, which suggests increased scrutiny is coming.
 
Fight modifier 24 denials with this cover letter
12/08/2014
by: Roy Edroso
Manny Oliverez, CEO of Capture Billing in South Riding, Va., swears by a cover letter his billers use on claims with the problematic 24 modifier, along with good documentation.
Denial rates with modifier 24 highest among podiatrists, urologists
12/08/2014
by: Roy Edroso
General surgery and orthopedic surgery are among the top 10 specialties in which modifier 24 denials occur, but they aren’t the leaders: Podiatry, urology and dermatology outpace them in denial rates.
CMS official at AMA Symposium: Bill CCM on last day, use any POS
11/24/2014
by: Roy Edroso and Laura Evans

For monthly chronic care management (CCM) services, practices should bill the claim on "the last day of the calendar month for which the CCM service is billed," according to a senior CMS official.

 
Steep Medicaid rate cuts loom over practices in most states as federal funds set to expire
11/24/2014
by: Richard Scott
For many providers, Medicaid reimbursement rates are set to take a nosedive come 2015, and physician practices are being advised to plan accordingly.
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