Part B News | Part B News

When providers get in trouble, keep quiet until it’s resolved, then reach out

10/06/2014

If one of your physicians leaves the practice under a cloud, even if his or her alleged offense directly affects your patients, be careful about releasing information about the situation to patients and staff until you have legal clearance to do so.

Part B providers have most success appealing RAC decisions at first level

10/06/2014

by: Karen Long

While almost 62% of Part B providers had denied claims overturned at the first level of appeal, just 18% had success at the second level.

EHR attestation site issue threatens some providers with unexpected 1% penalty

09/29/2014

by: Roy Edroso

A glitch in CMS’ electronic health records (EHR) attestation website has put many first-time meaningful use attesters in jeopardy of a 2015 negative payment adjustment of 1%.

4 ways to get in on those great new ACO savings — even without joining one

09/29/2014

by: Roy Edroso

You can improve your costs of care by following the formulas of successful accountable care organizations (ACOs), which have qualified for shared-savings payments of $445 million.

You’ll need a modifier to bill cath placement, studies with embolization

09/29/2014

by: Laura Evans

Vascular embolization and occlusion codes 37241-37244 — added in this year’s CPT manual — received a number of new component codes in Version 20.3 of the National Correct Coding Initiative (CCI), which takes effect Oct. 1.

Hepatitis C screening approved for coverage; pay details may take until Nov.

09/29/2014

by: Scott Kraft

You now can bill and get paid for hepatitis C screening tests for high-risk patients and for one lifetime test for any patient born between 1945 and 1965. But it may take until November to know how much you’ll get paid for the lab test, billed with new code G0472.

Think small: How you can reduce readmission rates like a small practice

09/29/2014

by: Ben Hartman

Reduce your hospital readmissions through scheduling flexibility, maintaining relationships with patients and communicating clearly with facilities.

Clarification about how to use new X modifiers starting Jan. 1

09/29/2014

by: Laura Evans

Question: Are the new modifiers for use in January 2015 (XE, XS, XP and XU) valid only on procedures and not to be used on E/M services?

Primary care billing more 99214, fewer 99213 and 99215 claims, data show

09/29/2014

by: Karen Long

If your internal medicine or family practice providers bill more than 90% of your established-patient E/Ms as level 3 and level 4, you could end up on an auditor’s radar.

Choose a PQRS reporting method by Sept. 30 or risk 2% or more in payment cuts

09/22/2014

by: Roy Edroso

Decide whether your practice will report physician quality reporting system (PQRS) measures as a group or individually by Sept. 30. You’ll have to register to use the group practice reporting option (GPRO) by that date if your practice wants to report as a group or, if your group has at least 10 providers, you’ll risk at least a 2% cut to 2016 payments.

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