CMS is directing your Medicare Administrative Contractor to add seven remittance advice remark codes (RARC) to its list of codes detailing payment adjustments, appeal rights and other claims information.

You have another option to earn a bonus through CMS's Physician Quality Reporting Initiative (PQRI) in 2011, but be prepared to act fast if you're interested. CMS is proposing to open its group reporting option to physician practices with less than 200 providers next year, but will limit the number of groups that can participate in the group reporting option for 2011.

CMS is planning to offer your practice an extra bonus payment next year through another quality initiative. Incentives will equal 0.5% of your Medicare charges from 2011 through 2014 - yielding anywhere from an extra couple hundred to thousands of dollars per provider each year.

Take extra caution when reviewing a patient's new health coverage information when it doesn't look familiar - instances of patients buying fake health insurance are on the rise, sticking your patients and potentially your practice with big bills that will be difficult or impossible to collect.

Adopting CMS's meaningful use standards may turn out to be worth even more than $44,000 in incentives promised by the agency. Private payers are lining up to base their own incentives on the CMS meaningful use rules, too. "It would make no sense for us to make our own standards," says one private payer.

You could be subjected to an audit when attempting to earn up to $44,000 per provider in Electronic Health Record (EHR) Incentive Program bonuses. CMS says it's creating an audit program to make sure those who attest they've met meaningful use requirements actually did. How CMS will audit the validity of an attestation in 2011 remains to be seen. The agency says only in the final rule that it's developing an audit strategy to address fraud and abuse risk.

You'll have to keep waiting for CMS to reprocess claims to account for several retroactive changes to the 2010 Medicare Physician Fee Schedule. CMS hasn't set a mechanism to efficiently reprocess claims and Congress has yet to appropriate funding for the effort. "Because of the large number of past claims that must be reprocessed, we are still working on the best process to handle the work load most efficiently," a spokeswoman tells Part B News.

CMS wants to pay practices up to $20,000 annually for participating in a new, two-year demonstration program designed to test whether the use of clinical decision support systems can improve the appropriate ordering of advanced diagnostic tests. The program, dubbed the Medical Imaging Demonstration, is open to practices who ordered at least five CT, MRI and/or Spect myocardial perfusion imaging (MPI) procedures for Medicare beneficiaries during 2009.

Take a second look at reporting these quality data codes whether you are new to or currently participating in the Physician Quality Reporting Initiative (PQRI). A Part B News analysis shows PQRI participants have a higher degree of success with certain quality measures. Providers correctly submitted quality codes 78.25% of the time, up 10 percentage points from the 2008 reporting period, according to numbers released by CMS in June.

Eligibility in the Electronic Health Record (EHR) Incentive Program is open to hospitals and physicians who aren't hospital-based. But what about those who don't fit exactly into either of those categories? This week, CMS answered questions posed by Part B News readers on the eligibility of physicians who practice in ambulatory surgery centers (ASCs) and nonhospital-based physicians working in multiple locations.