Sending a little extra documentation to your Medicare Administrative Contractor (MAC) may help you avoid Medicare denials when it comes to billing dual-energy X-ray absorptiometry (DEXA) scans, more frequently than Medicare usually allows, in cases that are medically justified.

Keep an eye on your local Blue Cross Blue Shield plan. The national class action settlement the Blues agreed to in 2007 expires May 31. That means that Blue Cross plans may not be as physician-friendly as they had been for the past four years.

This chart shows the results of a comprehensive salary survey conducted at the end of 2010 by Medical Practice Coding Pro, published by DecisionHealth. The top-paid job was compliance officer, which averaged $79,227 in 2010, a figure that shocked the practice manager of a 12-provider family practice in Lancaster, Ohio. “Wow, that is high,” she says. “I’ll just have to ask for a raise.” But the billing manager of a six-provider urology practice in Seattle wasn’t surprised by the salary.

This week’s question is answered by Regan Bode, CPC, CPC-H, CPMA, CEMC, ACS-EM, content manager for DecisionHealth and consultant for DecisionHealth Professional Services.

Having non-physician practitioners (NPP) conduct the newly required face-to-face visits for the initial certification of home health services may save your practice time and money.  
“I don’t know why a physician wouldn’t have a [NPP] do the visit,” said Ann Rambusch, who heads her own home health consulting firm in Round Rock, Texas. “It frees up the physician’s time.”
 

You will see automatic denials when your non-physician practitioners (NPPs) serve as either the attending or consulting provider for a patient who’s been admitted, experts tell NPP Report. Both the attending and consulting NPP will erroneously receive denials, which must be appealed in order for any money to be recovered.

These charts analyze the difference between non-physician practitioner (NPP) and physician use of E/M services by the patient type from 2006 to 2009. Utilization trends for E/M services are consistent for both new and established patients, with NPPs seeing increases over the four-year time window and physicians seeing decreases. NPPs saw a greater percent growth than the percent decline seen by physicians, but the sheer volume of physician vs. NPP use of E/Ms means that NPP growth is far too small to account for the decline in physician utilization.

Q. Could you tell me who can bill for the smoking cessation? Can a pharmacist, registered nurse or our midlevel providers?

Your peers are feeling far more impact from the slumping economy than from changes in the Patient Protection and Affordable Care Act (PPACA), better known simply as the health reform law. As far as the impacts of health reform, they will be implemented over the next eight years, with the vast majority of provisions in place by 2014.