This week's question is answered by John Burns, CPC, senior consultant for DecisionHealth Professional Services.

Q. How many days of concurrent care does Medicare allow? When a specialist and the attending physician bill daily visits for the same diagnosis, is there a limit? I try to coordinate with the other doctors, but it is not always possible.

Summary: Primary care specialties' utilization of top imaging services spanning all four major modalities continued to fall in 2008, in keeping with a trend identified earlier this year (PBN 3/23/09). 

Physicians must meet these 24 requirements must in order to achieve meaningful use and earn the federal incentive bonus -- according to CMS's current proposed meaningful use rule.

You'll notice the 2010 conversion factor ticked upward starting Jan. 1, leading to higher payments for some services. The conversion factor is now $36.0846, up just a fraction of a percent from $36.0666 in 2009. Beware: The conversion factor will plummet by 21.3% on March 1 unless Congress acts again (PBN 1/4/10).

You'll need to meet meaningful use daily from July 1, 2011 to Oct. 1, 2011, to get your first, $18,000 piece of the government's electronic health record system (EHR) incentive bonus. Even though all you have is a proposed rule, you must take steps now to ensure you'll be able to meet the meaningful use deadline in 2011.

You might have a fully certified electronic health record (EHR) system, but you're all but certain to need more upgrades and more money to achieve meaningful use as defined by CMS's proposed meaningful use rule, experts tell Part B News.

The 21.29% cut to your payments has been delayed until March 1, 2010 but more than half of all geographic areas in the United States still face a decrease in payments before then. Congress passed a two-month pay fix with the hope legislators will draft a permanent fix by March 1 (PBN 12/21/09). The temporary fix, signed into law by President Barack Obama Dec. 19, prevents the the cut from taking effect until Feb. 28. However, the minimum work geographic practice cost indices (GPCIs) floor of 1.000 expired Jan. 1.

Although many practices may be tempted to scale back or eliminate employee events during the shaky economic climate, many experts believe cutting morale-boosting occasions will cause long-term and short-term detrimental effects.

A top CMS official says you should have no doubts: come April 5, 2010, you will see rejections on any and all Part B services ordered or referred by physicians who are not in CMS's online Provider Enrollment Chain Ownership System (PECOS).

The concept of “doing today’s work today” through open access or same-day scheduling has been well known in practice management circles for years, and most practices that have tried it can vouch that adopting this technique increases patient, employee, and physician satisfaction and decreases no-shows and wasted work.