Hiring a certified registered nurse anesthetist (CRNA) straight out of school can cause headaches when you try to enroll the provider into the Medicare program. The CRNA needs to have a set of certifications and licenses before he or she can be enrolled and start receiving Medicare payments. 

Summary: How often are non-physician practitioners (NPPs) billing directly for office visits? This chart measures E/M billing by most NPP types at the state level, expressing E/M utilization as a percentage of all NPP services billed to Medicare in each state.

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: Can NPPs bill directly for administering flu and pneumococcal vaccines using roster billing? Can these vaccinations be billed incident-to? What is the best strategy?

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. Two of our major payers - one of which is Medicare and the other is Healthpoint, the distributor for OASIS - disagree on the right CPT codes our physicians should use for the application of the product. Healthpoint suggests codes 15430-15431 (apply acellular xenograft) would be appropriate. Who's right?

You'll need seven components - whether they're contained within one electronic health record (EHR) system or spread out in modules from different vendors - to meet stage 1 meaningful use criteria, experts say. This concise illustration shows which functions and capabilities are performed by each component, as well as how they work together.

Summary: Do some states or regions tend to bill more imaging services to Medicare than others? This chart looks at state-level utilization of common imaging services based on the latest CMS claims data, from 2008. To account for differences in state populations, the chart measures number of imaging services billed per single enrollee.

Starting in 2011, CMS will waive the copay for the scantly utilized abdominal aortic aneurysm (AAA) screening, removing an obstacle to the service and, in the process, potentially creating a new revenue opportunity for your practice. However, the service isn't open to everyone and you must meet requirements to bill the service G0389 (ultrasound exam, AAA screen, $108.78).

The swine flu/H1N1 scare is over and you won't be separately billing for swine flu during the 2010-2011 flu season. The seasonal flu vaccines you administer to your patients this flu season will have strains of the H1N1 virus included. "There is no longer a pandemic but it's in there," says Cynthia Hughes, CPC, the American Academy of Family Physicians' (AAFP) coding and compliance specialist.

Uninsured and underinsured patients are flocking to discount health plan programs to obtain medical services at a discount. These programs, known as discount medical card programs or referral plans, aren't illegal. But they're not actual insurance plans and can create problems for you when patients have an inflated sense of their own coverage.

You and your peers electronically prescribing controlled substances to patients can count these encounters toward earning a bonus from CMS's Electronic Prescribing (e-prescribing) Incentive Program, CMS says. The encounters also will count toward thwarting e-prescribing penalties in future years.