Part B News
06/29/2009

Your speech language pathologists now have a two-digit specialty code to specifically designate them as a provider type. 

06/29/2009

Physical and occupational therapists take note: Enforcement officials may already have your claims under the microscope.

06/29/2009

You and your peers are billing consultations rendered by physician assistants (PAs) and nurse practitioners (NPs) in increasing numbers every year, a Part B News analysis has found. In fact, the number of consults billed by NPs and PAs is up 874.3% since 2000. It's a trend that could mean additional money for your practice.

06/22/2009

You won't see as many large swings in prices as you have in the past for drugs billed to Medicare starting July 1. The average sales price (ASP) calculations remain relatively stable for the third quarter, with prices increasing less than 1% on average, according to an exclusive analysis of the CMS's quarterly ASP drug list by Part B News.

06/22/2009

When a physician creates an arteriovenous graft in a patient for dialysis (36821, $656.05 [fac.]), it has a 90-day global post-op period. But if the graft occludes within the 90 days and the patient has to have a thrombectomy (36831, $453.36 [fac.]), would you use modifier 78 (unplanned return to OR) or 79 (unrelated procedure during post-op period) on the second procedure?

06/22/2009

Download this month's tool from DecisionHealth Professional Services from Part B News' NEW Web site, www.partbnews.com. The Tool of the Month is a Recovery Audit Contractor (RAC) appeal tracking form. The purpose of this form is to allow providers to track all of the different timelines of an appeal your practice will encounter.

06/22/2009

This chart shows the top 10 CPT codes with the highest percent growth in allowed charges from 2007 to 2008. Like last week's Benchmark, all data comes from an April 2009 report by the AMA called "Estimated change in SGR spending from 2007 to 2008." The presence of codes like 97110 (therapeutic exercises, $28.13) isn't a surprise, since its utilization has been growing for years (PBN 11/24/08).

06/22/2009

You'll find in the latest batch of Correct Coding Initiative (CCI) edits that nearly a third of them include anesthesia codes, including hundreds of deleted pairs involving cardiovascular stress tests and anesthesia codes that have been around since 2003. The CCI changes take effect July 1.

06/22/2009

Specialty groups affected by the recent and continuing cuts for dual-energy X-ray absorptiometry (DEXA) services are mounting an intense advocacy campaign to convince Congress to restore payment rates, Part B News has learned. There are already two bills in Congress that would return DEXA payment rates to their 2006 levels, when the primary DEXA code was paid approximately $140 on average, about 60% more than the $53 it will be in 2010, says Andrew Laster MD, president of the International Society for Clinical Densitometry (ISCD) and a practicing rheumatologist.

06/22/2009

With the permanent recovery audit contractor (RAC) program on the verge of kicking off, you can keep the attentions of your regional RAC away from your practice by voluntarily handing overpayments directly to your carrier. This strategy will also reduce your compliance risk from recent legislation, experts say. Voluntary repayment to your carrier will preempt a RAC audit for that missing money that could include time-consuming medical record requests and other administrative hassles, a health care attorney tells Part B News.  

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