Don't expect to see interim reports on your Physician Quality Reporting Initiative (PQRI) performance in 2010. CMS says it considered the idea, but could not provide the feedback on time in a secure environment. Most errors are caused by coding mistakes or failing to report on 80% of eligible cases, the agency notes. It will attempt to provide aggregate performance data for all respondents on a quarterly basis.

Your practice must stop billing consult codes on Medicare claims starting Jan. 1. Instead, you'll use the appropriate inpatient or outpatient visit codes. The codes affected are outpatient codes 99241-99245 and inpatient codes 99251-99255.

You're just seven weeks away from a 2010 conversion factor (CF) that's a shocking $7.66 less than the 2009 CF, unless Congress steps in with a pay fix, according to the final 2010 Medicare Physician Fee Schedule (PFS; see Part B News Special Report). The conversion factor is slated to drop to $28.4061 from $36.0666 on Jan. 1, though experts and Washington insiders believe a pay-fix is inevitable (PBN 11/2/09).

There are lots of little details contained in the 2010 Medicare Physician Fee Schedule (PFS) that you need to know about to be prepared to bill correctly and project your reimbursements for 2010.

You and your peers flocked to perioperative, health information technology (HIT) and diabetes measures to earn incentive bonuses from the Physician Quality Reporting Initiative (PQRI) in 2008, according to a Part B News analysis of CMS billing data.

Expect implementation of the Red Flag Rules to move forward on Nov. 1 without further delay. The Federal Trade Commission (FTC) had delayed the rules for a year to provide more education to the various businesses affected - including your practice.

You're not likely to actually suffer a 21.5% cut to your Medicare payments on Jan. 1, 2010, despite the recent failure of a pay-fix bill to pass the Senate. Instead, expect a one or two-year fix to increase your payments by a small amount, experts say.

You can now bill for four previously uncovered cardiac MRI codes that involve blood flow/velocity quantification, Part B News has learned. In Transmittal 1831, released October 16, CMS is stripping off its blanket non-coverage for these procedures, leaving it up to carriers. If your carrier decides to offer coverage, you have a major new billing opportunity that could result in significantly hire payment for the remainder of 2009.

Expect to see a Medicare pay-fix no matter what happens to health reform. But a pay-fix is just the tip of an iceberg of physician-friendly provisions that could become law by year's end, experts say. Here's a breakdown of key reform provisions favoring you and your peers.

CMS struck down a 25-year non-coverage determination for cardiac MRIs that measure blood flow, but your carrier still has the power to deny coverage. Here are four ways to help persuade your carrier to make a positive coverage decision.