Independent diagnostic testing facilities are on the hook for the new $505 enrollment fee that also affects durable medical equipment (DME) suppliers, according to the CMS transmittal.

How does the ratio of services done in inpatient versus outpatient settings vary by specialty, and how have these ratios been trending over the last few years? This chart examines the distribution of providers’ services by their specialty between the two big inpatient place of service (POS) codes 21 (inpatient hospital) and 23 (emergency room), and the two outpatient POS codes, 11 (office) and 22 (outpatient hospital).

If the reason for the EKG during the pre-operative exam is the fact that it IS required by the hospital or the physician performing the surgery what diagnosis code should we use for the EKG?

Your physicians will receive bonus cash from Medicare under the Primary Care Incentive Payment (PCIP) program based on their specialty designation – which means specialists who were board-certified for a primary care specialty could potentially get the bonus. Some practices had reported physicians receiving the PCIP bonus; the latest are several cardiologists at an Oklahoma practice who got payments of about $1,300 each.

Rest a lot easier if your practice bills for the technical component (TC) of advanced diagnostic imaging services: CMS is backing down on a rule that would’ve created a massive Medicare enrollment burden for imaging groups. The result is that your CMS-855 forms won’t change as much, while whomever handles credentialing for your practice will have less work to do.

The Medicare Trust fund is set to go bankrupt in 2024, according to the latest annual Medicare Trustees Report, five years earlier than projected last year due to a sluggish economy, health care cost hikes and tax breaks. Realistically, if the spending is growing faster than the gross domestic product (GDP) then there is no way its affordable to the public or the country.

The Office of Inspector General warned you and your peers on May 18 about some features of electronic health records (EHRs) that could endanger your business and lead to False Claims Act violations.

You could get more use and money out of your electronic health records (EHR) system if you are enrolled in Medicare and Medicaid and qualify for incentive bonuses under both programs. If you are already planning to demonstrate meaningful use under the Medicare EHR incentive program, it’s worth checking to see whether you can also qualify for bonuses under your state’s Medicaid incentive program.

Do specialists, primary care providers or non-physician practitioners (NPPs) see drastically different denial rates and utilization for inpatient Medicare services? This chart addresses this question by analyzing both the utilization and denial rates of inpatient codes, based on the latest available CMS claims data from 2009.

My office implemented a certified electronic health records (EHR) system this month. We are now discussing e-prescribing and meaningful use requirements and the associated bonuses. I realize that we cannot earn a bonus for each program in the same year.  We think we should wait until next year to pursue the meaningful use bonus and concentrate this year on e-prescribing. If we take this approach, we want to make sure we won’t in any way compromise our ability to fully realize the meaningful use bonus by waiting until next year. Does this sound like a sound approach?