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New MBIs mostly in patients’ hands — but watch for duplicates

01/27/2020

Both CMS and OIG say the drive to connect every Medicare beneficiary with their new Medicare beneficiary identifier (MBI), which has been required for claims since Jan. 1, has been successful.

Modifier 25 Decision Tree

01/22/2020

Modifier 25 indicates a "significant, separately identifiable E/M service." Incorporate the tips below and click the "Download file" link above to access a modifier 25 decision tree.

If you’re expanding, don’t overshoot fair market value — or you may face the feds

01/20/2020

by: Roy Edroso

The fallout of a recent whistleblower case involving physician practice acquisitions serves as a warning that, if you’re making a big deal to grow your practice, you must have either a safe harbor or a really good explanation.

X marks the spot, part two: 5 additional scenarios primed for X modifier use

01/20/2020

by: Jim Dresbach

At the end of December, Part B News introduced a “how to” article explaining correct reporting of the four X modifiers – XE, XP, XS and XU – that, in some instances, offer a more specific alternative to modifier 59 (Distinct procedural service).

CDC introduces emergency ICD-10-CM vaping code as ban hits nationwide

01/20/2020

by: James Dresbach

Ongoing government intervention with vaping products has again made headlines during the first weeks of the new decade. The Food and Drug Administration (FDA) has proposed banning the sale of all flavored cartridge-based e-cigarettes. Analysts estimate that the flavored e-cigarettes accounted for roughly 80% of retail-store e-cigarette sales in 2019.

Prepare for proposed Stark and anti-kickback rules by planning ahead

01/20/2020

by: Marla Durben Hirsch

New proposed rules from CMS and OIG that would soften the Stark law and anti-kickback statute may bring some welcome relief for physicians.

Report unlisted code for pleural catheter declotting procedure

01/20/2020

by: Laura Evans

Question: The physician is performing a pleural catheter flush using saline with manual clearance of clots under ultrasound in the outpatient setting. Should we bill an E/M code (99212-99215) depending on documentation or some other code?

Nurse practitioners, physician assistants kept rising in 2018, but other NPPs faltered

01/20/2020

by: Roy Edroso

Even before the accommodations that CMS made for non-physician practitioners (NPPs) kicked in this year, the two biggest NPP specialties in Medicare were performing in overdrive. Other NPP groups, however, are falling off the pace.

New for 2020: Suite of CPT codes cover digital, patient-initiated E/M services

01/13/2020

by: Shelley C. Safian, PhD, RHIA, HCISPP, CCS-P, COC, CPC-I

Say hello to a fresh set of E/M codes, effective Jan. 1, 2020, for patient-initiated services with a physician or other qualified healthcare provider.

For success in 2020, map out a strategic plan based on long-term thinking

01/13/2020

by: Roy Edroso

While it’s always a good idea to have regular meetings to discuss day-to-day practice operations, the beginning of a new year is a good time to think about strategy and whether or not you have to shift gears to make it in 2020. Then put those ideas into practice.

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