Part B News
10/21/2010

Physicians from around the country have told CMS they will stop treating Medicare patients if a 23% cut hits their reimbursements on Dec. 1. The 2011 Medicare Physician Fee Schedule will be finalized by Nov. 1 and the 2011 conversion factor will reflect the 23% cut and another 6% reduction scheduled for Jan. 1.

10/21/2010

You'll face a wide-ranging series of changes to surgery coding under CPT 2011, an exclusive Part B News analysis shows. These changes bundle previously separate codes into one code and are likely to reduce payments for cardiologists, orthopedic surgeons, general surgeons and neurosurgeons, experts believe.

10/21/2010

You'll find three new E/M codes in your 2011 CPT book, along with significant bundling of surgical codes likely to negatively impact cardiology and surgery practices, experts tell Part B News. Some codes, new and revised, appear out of sequence, a tactic the AMA began in the 2010 CPT book. The three new E/M codes, for "subsequent observation care," are resequenced.

10/21/2010

Your doctors might think documentation shortcuts save time and boost efficiency, but they could also raise your practice's audit risk when government inspectors come knocking, experts tell Part B News. E/M documentation that looks similar or identical for different patient encounters will be scrutinized by the HHS Office of Inspector General (OIG) starting next year.

10/21/2010

Remember to update your enrollment records when a physician or non-physician practitioner (NPP) leaves your group to protect your practice against possible fraud or false accusations of improper billing. The provider's National Provider Identifier (NPI) number will still be attached to your group's Provider Transaction Account Number (PTAN).

10/21/2010

You still have time to earn 2010 bonuses under CMS's E-prescribing Incentive Program. Qualifying for the bonus before 2010 ends could mean an extra $2,612 for every physician or non-physician practitioner (NPP) at your practice. That's the average amount your peers earned in 2009, according to CMS statistics.

10/14/2010

I have a two doctor OB/GYN clinic that also performs GYN surgery. If the patient needs a hysterectomy (58270) and urinary suspension (sling) repair (57288), one doctor will do the hysterectomy and the other will assist him. Then the other doctor will do the sling with the first doctor assisting. Both doctors are able to do both surgeries, but they split this up to gain more reimbursement (around $350.00). Is this compliant? We're getting paid by Medicare and other payers, but I feel that it is wrong.

10/14/2010

You and your peers beefed up use of modifier 8P during the 2009 Physician Quality Reporting Initiative (PQRI) program year. A Part B News analysis of CMS billing data shows a substantial increase of utilization of 8P (reason not otherwise specified) compared to the previous reporting year.

10/14/2010

This chart shows how Medicare utilization of top imaging services has shifted by specialty from 2008 to 2009. Each "pie" represents all imaging services billed to Medicare in a given year. NOTE: Diagnostic radiology and interventional radiology were excluded from the pie, because while their utilization has fallen steadily, it's still large enough to overwhelm the chart (they accounted for 95.7% of imaging utilization in both 2008 and 2009).

10/14/2010

You now know how much CMS will pay you for seasonal flu vaccines. Here is a list of influenza vaccine prices for this flu season.

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