Part B News
12/10/2009

Some of your peers are having a little trouble with modifier PC, one of the three modifiers for "never events." The modifier indicates "Wrong Surgery on a Patient," and it will trigger an automatic denial.

12/10/2009

Here's a round-up of other HCPCS changes you can expect in 2010 (see related story).

12/10/2009

Members of Congress could move to delay a 21.29% cut to Medicare payments set for Jan. 1 by just 30 days - buying them time to pass a permanent solution to a flawed pay system after New Year's Day.

12/10/2009

Here are the basic elements of the "Welcome to Medicare" exam. Providers who currently render the exam say they've developed checklists and guides to help document the exam. Below, you'll find links to guides to help you complete the exam.

12/10/2009

Pay no mind to rumors CMS will delay or even cancel its plan to eliminate consults. Not only is the change permanent, but CMS says it is days away from releasing the new modifier that will become necessary once consults are replaced with E/M visit codes.

12/10/2009

You could face a stream of denials even if your enrollment information is fully updated in CMS's online Provider Enrollment Chain Ownership System (PECOS). All it takes is a referral for an item or service - any service, including lab tests or even office visits - that comes from another provider whose information isn't up-to-date in PECOS.

12/10/2009

You finally have a clearer definition from the AMA for when an encounter should be a transfer of care vs. a consult, but the policy proved to be too late as far as CMS was concerned when it eliminated consultation billing.

12/03/2009

The AMA recently met with top CMS brass to request it delay its new consultations billing policy by a year, stating the changes will cause several billing problems. Specialty societies are also applying pressure. But CMS officials tell Part B News the agency has no plans to delay the consult change now set for implementation Jan. 1.

12/03/2009

As if the conversion factor for 2010 wasn't bad enough, now you can expect your payments to go down even more than you thought last month - unless Congress takes action. CMS adjusted the 2010 conversion factor downward, again, after correcting the relative value units (RVUs) for 14 codes. The conversion factor will be $28.3895 instead of $28.4061, representing just a fraction of a percent difference.

12/03/2009

You have not yet seen any private payers follow Medicare's lead and eliminate consultation billing. However, there are private payer issues you need to address before Jan. 1 because you can no longer bill Medicare for consults after that date (PBN 11/9/09). 

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