Part B News
04/30/2012

This chart shows how many providers from 15 specialties have received the $18,000 Medicare incentive payment for meeting meaningful use for their electronic health records (EHR) from May 2011 to March 2012. The totals below, when multiplied by $18,000, will tell you the total amount CMS has paid each specialty for meeting Medicare’s meaningful use qualifications.

04/30/2012

A change to the therapy cap calculation means more work for practices starting Oct. 1.

CMS will count therapy a patient received in a hospital outpatient department toward the cap, set in 2012 at $1,880 for occupational therapy and $1,880 for physical and speech therapies, said Stewart Streimer, director of CMS’s provider billing group during an April 17 call. CMS will not reprocess claims, but, starting Oct. 1 it will recalculate a patient’s services toward the therapy cap amount retroactive to Jan. 1, he said.

04/30/2012

Keep an eye on reimbursement policies for physician assistants and nurse practitioners and be ready to work with physician hospital organizations to prevent improper payments and compliance errors.

A private payer that doesn’t credential non-physician practitioners may allow you to bill your NPPs’ services under the physician’s national provider identifier (NPI). The payer might not require a supervising physician to be in the office suite during the service or visit. In this case the practice is able to receive the full fee schedule amount for the NPP’s work and the physician is free to provide other services.

04/30/2012

This chart shows the turnover rates last year of two types of non physician practitioners (NPPs) – physician assistants (PAs) and nurse practitioners (NPs). All data comes from the 2011 Physician Retention Survey, a joint effort of the American Medical Group Association (AMGA) and Cejka Search, a health care recruitment company.

04/26/2012

If a physician saw a patient for an E/M office visit, orders blood work (36415), which was performed by ancillary staff, and draws and sends the specimen to an outside lab for testing, can we bill for both the E/M service and the venipuncture?

04/23/2012

You and your peers have been leery about using CMS’ online Provider Enrollment Chain Ownership System (PECOS) for years, but two new upgrades have hit and they are making processing faster, especially for revalidations. First, a “fast-track” view was added in February that lets you skip doing an entire enrollment when revalidating information for providers already in PECOS.

04/23/2012

Payers may soon be required to use identifiers, just like your national provider identifiers (NPIs), to make it easier for providers to identify them and save the government time and money. But the change may prove inconsequential depending on how CMS utilizes the new IDs. Payers currently use numerous identifiers for their health plans, which often lead to misrouted or rejected claims and payment delays. 

04/23/2012

Regardless of what stage of ICD-10 implementation you achieved before CMS proposed a one-year delay this month, use the extra time to convince your physicians that ICD-10 training is essential. The necessity to take advantage of the additional year rather than perceive it as a chance to blow off preparation was a message reinforced in several sessions of the American Health Information Management Association (AHIMA) ICD-10 Summit in Baltimore last week.

04/23/2012

Don’t be quick to overlook Medicare’s new annual depression screenings because of the low RVU (0.51, $17.36). The preventive service is intended to take only 15 minutes and can be incorporated into your existing workflow with little effort.

“[CMS] is willing to throw a couple extra bucks to physicians and saying, ‘Not that you’re not already doing this, but we’re going to give you a little extra money if you do it in a formal way,’” says Joan Gilhooly, CPC, president of Medical Business Resources in Lorain, Ohio.

04/23/2012

Save your practice potentially thousands of dollars of recouped funds by using regular audits to find coding and documentation errors before your payers do.

“You don’t want your practice to lose money earned because you failed to find an error; you want to protect yourself,” says Tori Kreher, compliance officer for the Orthopedic Center of Southern Illinois in Mt. Vernon, who performs annual audits for her practice. “If you correct it, it won’t cause you as much [of a] problem in the long run.”

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