Part B News adaptation of "Threshold time for prolonged visit codes 99354 and/or 99355 billed with office/outpatient codes" from CMS Transmittal 1875 to the Medicare Claims Processing Manual.

Imaging-related specialties have seen their utilization for imaging services tumble between 2007 and 2008, continuing a rather uneven trend where orthopedic surgery alone sees noticeable utilization growth (PBN 3/30/09). NOTE: Diagnostic radiology, which has long been the top biller of imaging services, is not shown on this chart because it far outstrips these other specialties.

Can you give us some pointers for how to bill when the doctor is the attending physician for a hospice patient?

You suddenly stop getting payments for Medicare services, then days later, a letter from your carrier arrives with some bad news: You owe Medicare more than $100,000. It gets worse. Before you know it, bank liens are forcing you to lay off employees while you resolve the appeals process. Here's four steps you must take when your carrier suddenly starts forcibly offsetting alleged overpayments.

Changing Medicare's payment formula to break the cycle of large annual pay cuts and temporary fixes to your payments remains a top priority on Capitol Hill, Washington insiders tell Part B News. Top lawmakers are discussing options - including a multi-year pay fix - to avert the 21% cut to your Medicare reimbursements now set for March 1.

After a slow rollout, Recovery Audit Contractors (RACs) appear to be ramping up targets aimed at outpatient services furnished by you and your peers. Region D RAC HealthDataInsights (HDI), overseeing states in the West, is now targeting services billed for a new patient when the provider had seen the patient within the last three years.

Expect reports generated from consultation services to continue even though specialists are no longer required to draft a letter or note to the referring physician, practice consultants say. Under old billing rules, your physicians were paid more for consults because the services required more work and time.

Identify your patient's insurance plan and determine whether the payer still accepts consultation codes (see related story). The consult change does not apply to Medicare Advantage (MA) plans. However, some MA plans are following Medicare's lead to eliminate consult codes (99241-99245, 99251-99255). Others are signaling they will continue to bill consults.

CMS will require its contractors to make sure your providers can legally work in the United States, according to an update to the agency's enrollment policy. Contractors will identify physicians and non-physicians who indicate in section two of an enrollment application they were born in a foreign country.