Part B News
04/29/2013
CMS has given the whole industry a big heads-up on ICD-10, and many practices are behind schedule on preparedness. Don’t panic, our experts say — but do grab the best available resources, and get to work fast.
04/29/2013
Practices can start the process May 1 to become accountable care organizations (ACOs) in 2014, but even before that, your practice should take three steps to ensure the ACO’s success.
04/29/2013

The following graphs depict claims denial trends for therapy services listed on CMS’ “always therapy” code list that were billed in 2010 and 2011. These codes are eligible for the therapy cap rule, which requires use of the KX modifier (Requirements specified in the medical policy have been met) when therapy services for a single patient exceed $1,900 (PBN 1/14/13).

Note: Claims billed with the KX modifier were not included in the analysis because the modifier became active Jan. 1, 2011, and was not listed in CMS’ claims database. (Visit www.cms.gov/Medicare/Billing/TherapyServices/AnnualTherapyUpdate.html to download the full “always therapy” list. Look for more about the therapy cap in an upcoming issue of Part B News.)

 
04/29/2013
Take note of the nine new lab tests below that will be considered CLIA-waived by CMS, according to CMS transmittal 2671 to the Medicare Claims Processing Manual. Note that the codes listed below won’t appear new — in many instances, other tests billed with these codes are already CLIA-waived, but the specific brand of test is being added.
 
04/29/2013
A proposed rule defining how patients will receive assistance from qualified health care “navigators” to select the right health insurance exchange plan under the Affordable Care Act (ACA) aims to close the door on insurance broker and health plan participation, as well as any state law efforts to thwart ACA implementation.
04/29/2013
The 2% sequestration cuts to your Medicare payments could continue through March 31, 2014, if Congress takes no action, according to new sequestration Q&As posted on Medicare administrative contractor (MAC) websites such as Palmetto’s.
04/22/2013
Practices can start the process May 1 to become accountable care organizations (ACOs) in 2014, but even before that, your practice should take three steps to ensure the ACO’s success.
04/18/2013

You’ll soon have to use a new CMS form to enroll your practice to receive payments via electronic funds transfer (EFT), a payment type set to become mandatory in 2014 under implementation of the Affordable Care Act (ACA).

04/18/2013

Physician practices that offer therapy services, radiation therapy and advanced imaging could lose revenue and have to make operational changes if Congress votes to adopt a budget proposal to sharply limit physicians’ ability to bill those services in their offices.

 
04/18/2013

For some specialties, the across-the-board, 2% sequester cut to Medicare that became effective April 1 will be especially painful; experts advise you to prepare for the fallout.

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