Reimbursement for seven of the 10 top oncology drugs billed to Medicare have increased over the last three years under CMS's average sales price (ASP) lists, a Part B News analysis shows. However, the overall positive trend for most of these codes hasn't been consistent. NOTE: These codes were selected based on their overall utilization and on how frequently they were billed by a high-volume oncology practice in California. Remember: The 2010 pricing is based on the latest Q2 ASP list from CMS.

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A recent investigative report by the CBS Evening News revealed a little known secret about many digital copiers: The black box on the back is a hard drive that captures a copy of every document you run through it. The CBS story revealed that it is very easy to pick up a used copier and access that data.

Use modifier JW (Drug Amount Discarded/Not Administered to Any Patient) to get paid for leftover or unused drugs and biologicals discarded by the physician during a patient visit. CMS updated its Claims Processing Manual chapter on billing discarded drugs and biological with Transmittal 1962, which is effective July 30. The agency clarifies that you append JW to the service line noting the discarded amount and it will be reimbursed by the Medicare program.

There are at least three ways you can prepare your practice to weather major payment disruptions resulting from payer problems. An enrollment snafu or audit repayment demand can leave your practice thousands of dollars or more in the hole at any time - even if it's just temporary.

Hold off on resubmitting claims affected by recent Medicare payment changes to the physician fee schedule. Any resubmitted claim already paid under the old conversion factor will be denied as a duplicate claim - and will ultimately be a waste of your time.

You will also earn Physician Quality Reporting Initiative (PQRI) bonuses from some Medicare Advantage (MA) plans when you qualified to earn a bonus from traditional Medicare fee-for-service, CMS officials say. By now you should have received bonuses from certain MA plans for successfully submitting quality data during previous PQRI reporting years (PBN 12/15/08).

Your Medicare payments would be stabilized for the next several years under a plan put forth by Congressional Democrats that delays sustainable growth rate (SGR) cuts to Medicare until 2014. The provision - in The American Jobs and Closing Tax Loopholes Act of 2010, H.R. 4213 - contains "reasonable updates in physician payment rates" for the rest of this year and 2011. Rates also would increase in 2012 and 2013, but then would be subject to the SGR in 2014, according to a summary of the bill.

You and your peers are pressed to act quickly after a recent Federal Register rule moved up the deadline to July 6, 2010 from Jan. 3, 2011 to get your physicians into CMS's Provider Enrollment Chain Ownership System (PECOS) (PBN 5/10/10). A special CMS open door call on enrollment issues held May 19 may add to the confusion you're already feeling about compliance.

This week's question is answered by Sean M. Weiss, CCP-P, ACS-EM, CPC, CPC-P CCA-P, vice president and chief compliance officer of DecisionHealth.

Q. Dr. A. does an H&P on a Medicare patient that he admitted to observation status. He calls Dr. B., who works for a different practice, to consult for an orthopedic ordeal. Dr. A. charges the appropriate 9921X initial observation care code. Dr. B. charges a 9922X initial hospital care code. Who billed correctly?