This chart shows 2007 denial rates for several codes currently being targeted by Recovery Audit Contractors (RACs).

This week's question is answered by Margie Scalley Vaught, CPC, coding content specialist for DecisionHealth.

Q: My physician has many dialysis patients who go on cruises throughout the summer and fall months. Cruise lines now require a physical exam and note from the doctor before the patient can board the ship. Is there any way to bill Medicare for this service?

As we reported a couple of months ago, you may see expanded opportunities in 2010 to report clinical data under Medicare's Physician Quality Reporting Initiative (PQRI) using your electronic medical record (EMR) system (PBN 8/3/09).

Quest Diagnostics is trying to merge lab and pharmacy services by getting into the electronic prescribing business. The laboratory giant is expanding its Care360 Labs & Meds software suite - already in use by practices representing some 150,000 physicians, according to the company - to include e-prescribing functions.

Two recent studies published in the same journal last month reach interesting conclusions about two different forms of clinical decision support (CDS).

Your physicians are turning to social media - such as Facebook, Twitter, blogs, and YouTube - to communicate with patients, recruit staff and increase revenue. When you're not careful, your activities may leave your practice open to compliance risks.

Check your remittance advices today to make sure Physician Quality Reporting Initiative (PQRI) codes you're reporting are being accepted by your carrier. There's too much money at stake and staff time invested to risk losing your PQRI incentive bonus this year.

Review your provider's E/M documentation and watch for overuse of buzzwords such as "unremarkable" or "non-contributory," which don't clearly convey a provider's thoughts or intentions. Auditors also say that using vague phrases too often can indicate a physician is giving a canned answer, such as "see my intake history sheet in my chart, reviewed, no changes."

You'll hit a roadblock in CMS's online enrollment system when you try to reassign the benefits of an individual provider to your group. It's one more situation where you can't use the Provider Enrollment Chain Ownership System (PECOS).

Carefully consider your practice's patient demand, staffing situation and future payment rules when trying to decide between buying or leasing expensive diagnostic equipment. You'll save money and effort by doing lots of homework before taking a calculated risk, experts say.