This chart shows the 2010 denial rates of three frequently billed codes for seven Medicare-heavy specialties and compares those rates with the 2009 percentages. All numbers are based on a Part B News analysis of 2010 and 2009 Medicare claims data. Note: The 2010 codes selected had at least a 10% denial rate and a total service count per specialty of at least 10,000. Medicare paid at least $5 million per specialty in 2010 for each of these codes. 

Can you bill an E/M visit with modifier 25 (separate, significant E/M) if you are also billing G0446 (intensive behavioral therapy for heart disease risk)? (Here’s the link the subscriber provided to Palmetto’s policy: http://tinyurl.com/cdck6sv.)

You’re likely stuck if you got hit by the 1% e-prescribing (e-Rx) penalty this year.

Earlier CMS statements suggested you could call the QualityNet Help Desk to appeal, but QualityNet can tell you only why you got the penalty, a top CMS official tells Part B News.

Primary care practices could get a little extra money because of deleted edits that led to reimbursement changes in the latest National Correct Coding Initiative (CCI) edits. But most practices - other than neurosurgery, orthopedic, urology and oncology specialties - won’t see major code pair changes in 2012’s second quarter.

Instruct physicians to use adjectives to document how sick hospital patients remain during subsequent hospital visits – instead of writing “stable” or “improving” – to avoid claims denials.

Over the years, you have been unknowingly overpaid by Medicare because of changes in CMS’ fee schedule, but you’re going to have to pay it all back – potentially thousands of dollars – thanks to recovery auditor Connolly’s new probe.

A growing number of hospitals, plans and other entities are offering physicians subsidies for the cost of electronic health record (EHR) systems, but before agreeing to a deal, make sure it will benefit your practice.

This chart looks at national physician turnover rates based on two variables – number of physicians at the practice and the type of practice ownership. 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.

Is code G0289 (surgical knee arthroscopy with surgery to remove loose/foreign body or chondroplasty at the time of other arthroscopy on the same knee) still applicable even though CPT changed the descriptors of 29880 (surgical knee arthroscopy with meniscectomy [medial and lateral] including chondroplasty, same or separate compartment[s]) and 29881 (surgical knee arthroscopy with meniscectomy [medial or lateral] including chondroplasty same or separate compartment[s])?

This is a table of all retroactive deleted code pairs from CCI's version 18.1 second quarter edits. You can rebill and get separately paid for many of the services in the once bundled pairs.