Part B News
4 key questions to prepare for the changing rules of prolonged services
11/02/2020
by: Julia Kyles, CPC
When you train staff on the new rules for prolonged service codes, it’s imperative to know how to accurately capture time spent on an encounter and how to prepare for new guidance in 2021.
Payments, claims flow forth for lucrative psychiatric diagnostic codes
11/02/2020
by: Richard Scott
Provider payments for two psychiatric diagnostic evaluation codes (90791, 90792) maintained steady growth in recent years, returning more than $140 million in fees in 2018, the latest year of available Medicare claims data.
If SCOTUS kills ACA, prepare for uninsured patients till states, Congress act
10/26/2020
by: Roy Edroso
The Supreme Court is again weighing the fate of the Affordable Care Act (ACA) in California v. Texas, and the odds on its repeal seem higher than ever. Some experts think the ACA still has a good chance of surviving. But if all or part of it falls, even many of your non-exchange patients will have to rely on lawmakers to pick up the slack.
Audio-only services, E/M documentation updates major focus of PFS comments
10/26/2020
by: Richard Scott
Various stakeholders are calling on CMS to maintain the current payment rates for audio-only E/M services after the COVID-19 public health emergency (PHE) ends, and others want to see a permanent removal of telehealth restrictions.
E/M and stress tests: When to report a separately payable service with modifier 25
10/26/2020
by: Sarah Gould
Question: A patient with a history of hypertension and high cholesterol visits a cardiologist for an appointment, complaining of occasional chest discomfort during exercise. After the physician completes an office visit, it is determined that the patient needs a cardiovascular stress test, which is performed that day by the same physician. Would it be appropriate to report an E/M code for the visit with modifier 25 (Significant, separately identifiable E/M)?
Modifier 25 does well with E/M codes — and sometimes others
10/26/2020
by: Roy Edroso
Providers seem to vastly favor using modifier 25 (Significant, separately identifiable E/M service) in mid-level established patient visits over any other. But it gets a workout with other codes as well – some of them inappropriately.
Welcome third round of HHS relief funds, eased lending terms for accelerated payments
10/22/2020
by: Roy Edroso
If you took advantage of CMS’ Accelerated and Advance Payment Program, CMS has good news for your repayment responsibilities. And if you also took advantage of the CARES Act Provider Relief program, HHS has good news there as well.
Groups call on CMS to avert 2021 payment cuts, but does CMS have the authority?
10/19/2020
by: Richard Scott
The deadline to submit comments to CMS for the proposed 2021 Medicare physician fee schedule (PFS) passed on Oct. 5 and, judging by a preliminary look at the feedback, the federal agency is facing a number of difficult policy decisions. Perhaps most vexing is what to do about proposed revisions to schedule-wide pay rates that would have a substantial impact on practice revenue next year.
MDPP can help patients, but earnings are unlikely the reason to offer it
10/19/2020
by: Roy Edroso
Two years in as a billable service, the Medicare Diabetes Prevention Program (MDPP) has not achieved great penetration and does not promise large financial benefits for participating suppliers. But the benefit of care for patients is reported to be substantial, and under some payment models you may find the program worth offering.
The latest Correct Coding Initiative edits may have you seeing double
10/19/2020
by: Julia Kyles, CPC
Question: The latest version of procedure-to-procedure (PTP) edits contains hundreds of duplicate edit pairs. The only difference between the pairs is that the first is deleted and the second is valid. This is an example of what we’re seeing... The deletion date is always 12/31/2019. Is this a mistake or is there a reason some pairs look this way?
Prev Next

Login

User Name:
Password:
Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Quick Links
Learning Opportunities
See more...
Forum

The Forum is temporarily unavailable.

click icon to expand
Back to top
Privacy Policy
|
Terms of Use
|
© 2025 DecisionHealth, an HCPro Brand