You and your peers have not been able to bill Medicare for consults for nearly a year, but confusion remains over certain scenarios that involve whether to use new or established visit codes for some inpatient services. The fact that many patients receive a combination of Medicare and private coverage has also helped prolong uncertainty, experts say.

You'll benefit most from regional extension centers (RECs) if you're a small primary care practice, but many of these federally funded organizations will help specialists adopt electronic health record (EHR) systems as well - for a higher price.

You will receive special attention from the HHS Office of Inspector General (OIG) starting next year when your claims consistently contain errors (PBN 10/11/10). After conducting a four-year audit, OIG inspectors found a total of 740 Medicare providers they believed to be "error-prone" and deserving of special attention in the form of overpayment demands.

You and your peers lost more than $610 million in 2009 thanks to unusually high denials on the two lowest-level E/M visits commonly billed by physicians, new CMS data reveals. Established visit codes 99211 ($19.54) and 99212 ($39.84) suffered denial rates of 9.7% and 6.3% respectively in 2009, according to the latest CMS claims data.

Your path to quality reporting success in 2011 may be smoother based on where you focus your reporting efforts, a Part B News exclusive analysis reveals. Your peers heavily relied on electronic health record (EHR) use, perioperative care and prevention screens when attempting to earn bonuses from the Physician Quality Reporting Initiative (PQRI) in 2009.

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.  We have some debate in our office on when we can bill the lab handling code, 99000. Can we bill this any time we package up materials for the lab, or must we actually be the ones to take the specimen to the lab in order to utilize the code?

Summary: This chart shows 10 codes that saw some of the fastest growth in Medicare utilization from 2008 to 2009, based on the latest CMS claims data. NOTE: Codes billed less than 100,000 times annually were excluded from analysis.

Your chances of scoring up to $44,000 in per-provider electronic health record (EHR) bonuses could be a lot better with the help of a regional extension center (REC). A complete roster of 62 federally funded RECs have been assigned by the HHS Office of the National Coordinator for Health Information Technology (ONC), giving every practice in the country the option to get REC help.

Look for a CMS letter warning you to obtain accreditation for advanced imaging services or forgo thousands of dollars in reimbursements in 2012. Then act fast; don't get caught in a crush of providers trying to earn accreditation before the Jan. 1, 2012, deadline.

For all the talk about price transparency in health care, many private payers still won't show you their fee schedules even when you're a participating physician practice. This puts you in a terrible position. Without the fee schedule, you don't know whether fees are adequate or whether to negotiate for additional payment. You also don't know how much you'll get paid each time you submit a claim - the amount can vary on different claims for the same service.