Part B News
Correction
12/17/2012
Temporary SGR fix likely between Christmas and New Year’s, lobbyists say
12/10/2012
by: Ben Penn
Your Medicare rates are almost certainly safe from a 26.5% sustainable growth rate (SGR) cut set to take effect Jan. 1. Just don’t expect Congress to reach an agreement on a fix before the very last week of 2012, healthcare lobbyists tell Part B News.
 
Don’t return your meaningful use check; gather supporting documentation now
12/10/2012
by: Ben Penn
Secure your meaningful use incentive payments by carefully maintaining supporting documentation that proves all the measures you attested for through electronic health records (EHR) were reported accurately to CMS. Or you may have to return your hard-earned meaningful use check.
ALJ hearings will remain a good appeals option, OIG report notwithstanding
12/10/2012
by: Tina Irgang
Providers could soon lose a powerful ally in CMS’ appeals process. A new report from the HHS Office of Inspector General (OIG) means you likely will see CMS and its contractors participate more actively in administrative law judge (ALJ) hearings in an attempt to uphold denials.
Document time estimates, patient specifics to secure 99239 reimbursement
12/10/2012
by: Karen Long
Direct providers to document at least an estimate of how long it took to discharge a patient to support billing 99239 (Hospital discharge day management, more than 30 minutes) and avoid losing $33 per claim.
Benchmark of the Week: Discharge management denial rates, 99238-99239
12/10/2012
by: Ben Penn
This chart displays the hospital discharge management codes’ denial rates for the 18 physician specialties that used the codes most frequently in 2011. Based on a Part B News analysis of the latest Medicare claims data, the denial rates for both 99238 (30 minutes or less) and 99239 (More than 30 minutes) are presented for each specialty, presented below in alphabetical order.
Final 2013 Physician Fee Schedule: Estimated impact on allowed charges by specialty
12/10/2012
See how CMS' relative value unit (RVU) changes will affect your specialty in its 2013 Medicare physician fee schedule final rule.
Tool of the Month: CMS meaningful use audit spreadsheet
12/06/2012
by: Ben Penn
The first round of meaningful use audits has already begun for providers who already received their meaningful use incentive payment. Here is a copy of the spreadsheet file you'd use to submit your supporting documentation to CMS contractor Figliozzi & Company if you were to receive this intiial audit.
CMS introduces easy way to start PQRS reporting, avoid 2015 payment cuts
12/03/2012
by: Karen Long
Want CMS to do all of the work to satisfy physician quality reporting system (PQRS) requirements for you – helping you avoid a 1.5% cut to your Medicare payments? Sign up for the administrative claims-based reporting option in 2013, the only year it’s available. CMS will pull the data from your claims, and you’ll avoid the 1.5% payment adjustment in 2015.
 
5 tips from a thriving multispecialty ACO to achieve physician buy-in
12/03/2012
by: Ben Penn
Help overcome the biggest challenge of forming an accountable care organization (ACO) – persuading your physicians to abandon fee-for-service Medicare and receive reimbursements based on patient outcomes and efficiency – with guidance from two doctors who have won over their peers.
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