Part B News
12/16/2010

The latest version of the Correct Coding Initiative (CCI) edits (version 17.0) brings 19,595 new code pairs, deletes 9,559, and includes significantly more mutually exclusive additions and deletions than version 16.3. Check out the official Part B News CCI Scorecard for a complete breakdown.

12/16/2010

Your practice can see patients more quickly while making fewer paperwork errors using online, electronic patient registration tools, a growing technological trend that will boost your bottom line, practice managers say. Caveat: These services aren't free and come with a learning curve both for your staff and patients, which could slow you down at least temporarily when your existing paper-based system already works well.

12/16/2010

Expect to see physician involvement during medical necessity reviews conducted by Medicare Advantage (MA) plans, thanks to a new requirement proposed by CMS. This would prevent MA plan officials without direct knowledge of providing medical care from making unfavorable decisions when auditing your claims.

12/16/2010

Summary: This chart compares the denial rates for new and established office visits, levels 3 to 5, by specialty based on the latest CMS claims data from 2009. These specialties were chosen to cover a diverse array of practices. NOTE: Data labels indicate the actual denial rate for the level 3 and level 5, omitting level 4.

12/16/2010

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.

Q. It is my understanding you can bill a separate procedure during a non-covered [preventive care service] (99381-99397). Can the additional procedure be a visit such as a 99213? Which codes would get the 25 modifier?

12/16/2010

Your non-physician practitioners (NPPs) can play a huge role in helping your practice and patients reap the full benefits of Medicare's new annual wellness visit (AWV), experts tell NPP Report. Not only does the final 2011 Physician Fee Schedule allow NPPs to furnish the annual wellness visit, it also allows them to bill this new service incident to, without the physician needing to be in the same room.

12/16/2010

Congressional updates to the 2011 Medicare Physician Fee Schedule will provide a small boost to therapy services when compared to just a month ago. The multiple procedure payment reduction (MPPR) on therapy services has been further weakened and lawmakers elected to bring back the therapy cap exception next year.

12/16/2010

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.

Q. Do the surgery global periods apply to the assistant at surgery the same way that they apply to the primary surgeon?

12/16/2010

Summary: How does switching to an electronic health record (EHR) system affect the cost of having non-physician practitioners (NPPs) in your office? Few lengthy surveys are available, but this data from the Medical Group Management Association (MGMA) represents some of the most comprehensive so far. Even so, the data is limited to only a few specialty types.

12/09/2010

If the physician saw a patient that was in observation status for an E/M visit and performed a kidney biopsy on the same date of service as a result of the visit, will there need to be a modifier? The diagnoses are going to be the same, is that acceptable?

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