Part B News
11/09/2015

Our roundup of the rest of the Physician Fee Schedule, from the conversion factor to rural health clinics.

11/09/2015

This chart shows payments for commonly billed codes for three time periods:pre-MACRA. post-MACRA but pre-2016 physician fee schedule, and after the fee schedule kicks in.

11/02/2015

Medicare administrative contractors (MACs) may accept the provider’s initials along with amendments, additions or changes to the patient’s medical record, so long as the initials can be used to identify the provider from information elsewhere in the record, CMS says in transmittal 615 to Medicare’s Program Integrity Manual.

11/02/2015

Multiple Medicare administrative contractors (MACs) have reported ICD-10-related claims-processing snafus in recent days, which means you can expect delays in getting payment to flow to your accounts receivable department.

11/02/2015

Consider patient transport as part of your practice’s future as a new OIG Advisory Opinion (AO) appears to clear the way for providers with multiple addresses to provide shuttle van service to patients.

11/02/2015
11/02/2015

Question: A specialty surgeon discovers an issue during surgery that requires a second surgeon of a different specialty to come in to do a procedure separate from the original planned service. How do they bill?

11/02/2015

Use of modifiers 54 (Surgical care only) and 55 (Post-op management only) reduced or maintained denial rates when billed with some orthopedic services codes — but it was a different story for cataract surgery. 

11/02/2015
Since the Oct. 1 launch date of the ICD-10 code set, Medicare payers have reported a number of claims-processing errors affecting dozens of codes.
 
Those problems include codes listed on local coverage determinations (LCDs) and national coverage determinations (NCDs), notes Teri Jorwic, professor of health care informatics at the University of Illinois at Chicago.
 
"There have been reports that some of these lists seem incomplete or inaccurate," says Jorwic. "For example, in the injury codes there are a minimum of three 7th characters for initial, subsequent and sequela. Some are reporting that only some of these 7th characters are being accepted."
 
Download the "ICD-10 errors" spreadsheet (link above) to view all codes entangled in errors in your Medicare administrative contractor (MAC) jurisdiction.
 
10/26/2015
In this enrollment season, it’s good care and service to help patients with their Medicare and Affordable Care Act (ACA) plan enrollment. But be careful about seeming to steer them to particular plans.

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