Non-physician practitioners (NPPs) are seeing a high denial rate on low-level E/M codes, according to an NPP Report analysis of the latest CMS claims data. 99212 (office/outpatient visit, est., $37.15) was denied an astounding 20.2% of the time in 2008 - that's more than one denial for every five claims submitted. 99211 (office/outpatient visit, est., $18.75) had a 40.6% denial rate in 2008.

Physical therapy and chiropractic manipulation codes remain the fastest-growing but most often denied services for non-physician practitioners (NPPs), according to an NPP Report analysis of the latest CMS claims data.

Can an NPP bill a time based code "incident-to"? I've heard various opinions on this and would like a source from Medicare that gives the correct answer.

Your staff is not immune to the highly contagious swine flu virus now widespread in 37 states, according to the latest data from the Centers for Disease Control and Prevention (CDC). The difference is that when your patients get sick they'll count on your practice. You need a plan for how to run your practice when half your staff - or their children - get the swine flu.

Now is the time to make sure you're ready to act quickly when you receive a letter from your RAC. You've likely not heard a peep from your RAC as they have been slow to send out demand letters (PBN 9/21/09). But experts have recommended you develop a RAC response team to respond to RAC letters and deadlines (PBN 3/9/09).

Take a look at hyperbaric oxygen chambers for wound therapy treatments at your practice - more and more of your peers are billing these services, a Part B News analysis shows. CMS allowed billing physician attendance and supervision of hyperbaric oxygen therapy (99183, $189.35) for lower extremity wounds in diabetics in 2003 (PBN 1/13/03). The volume of services billed has more than doubled since then - with 465,406 services in 2008, up from 212,258 in 2002.

Does your carrier have the right address for your practice? Verify your practice location with your carrier if you have any doubt the right address is on file. It could save you from having your billing privileges revoked when the carrier visits your on-file address to find that you're not there anymore. 

Sometime between now and Nov. 30, Medicare carriers will be sending solo doctors and non-physician practitioners (NPPs) some informational brochures. There's nothing newsworthy about the brochures, but here's the catch: when they go to an invalid address, the Medicare billing privileges for the provider tied to that address will be deactivated.

How would you feel about a three-year break from new diagnosis codes? That is just one option under consideration by the CMS and the Centers for Disease Control and Prevention (CDC) to ease the burden leading into the Oct. 1, 2013, implementation of ICD-10-CM/PCS.

Region B's Recovery Audit Contractor (RAC) has released targets for all seven states in its jurisdiction: Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin. The Oct. 14 release means all 50 states now have targets.