Part B News
Some plans still pay higher fees for consults — but don’t mix them up with transfers
10/21/2019
by: Roy Edroso

Medicare won’t pay, but consultation codes can still be part of your tool kit if you have the right private payers and know how to use them. 

CMS, OIG propose new safe harbors, exceptions to free up value-based care
10/21/2019
by: William Maruca
As part of an effort entitled the Regulatory Sprint to Coordinated Care, CMS and OIG released advance copies of proposed regulatory changes on Oct. 9. The proposed rules would modify regulations that have presented obstacles to physicians, hospitals and other providers as they transition away from traditional fee-for-service (FFS) payment models toward value-based arrangements.
For practices seeking a virtual boost, time could be now to make RPM motors hum
10/21/2019
by: Jim Dresbach
Coders should be in the know about CPT codes 99091, 99453, 99454 and 99457 and the changes occurring in the growing realm of remote patient monitoring (RPM) services.
Get holistic: 4 tips to enhance coding for E/M and psychotherapy services
10/21/2019
by: Richard Scott
Work a few key measures into your coding routine when reporting E/M services and add-on psychotherapy codes, such as focusing on your distinct therapy time, to sharpen your claims reporting for a trio of oft-reported codes.
Stay up to date with the 2019-2020 influenza season with Medicare-approved codes
10/21/2019
by: Jim Dresbach
Update your annual flu forecast: Influenza immunization codes and payment allowances are now available under Medicare, and providers and health experts are offering forecasts on the severity — or the mildness — of the 2019-2020 flu season in the U.S.
Providers favor standalone psychotherapy codes, and the longer the better
10/21/2019
by: Richard Scott
When reporting a series of oft-used psychotherapy services (90832-90838), providers tend to stick to a pattern of long-duration standalone codes and shorter-duration add-on codes.
New enrollment deactivation guidance provides uniformity, ‘rebuttal rights’ to providers
10/14/2019
by: Roy Edroso
An extensive manual change concerning enrollment deactivations suggests that CMS is trying to make it easier for providers to avoid the hassle of accidental removal — but you still have to know and follow the rules.
Bypass chronic care management barriers that suppress revenue, care plans
10/14/2019
by: Jim Dresbach
Many practices are now performing chronic care management (CCM) services — the non-face-to-face consultations provided to patients who have two or more chronic conditions — yet providers continue to encounter significant barriers in completely connecting eligible patients to such care.
Executive order seeks Medicare FFS payment redress, MA plan proliferation
10/14/2019
by: Roy Edroso and Richard Scott
Proponents of Medicare Advantage plans will find likeminded support from the White House, which seeks to counter single-payer health program proposals with a renewed focus on “market-based approaches in the current system,” according to an Oct. 3 executive order released by President Trump.
As Medicare inspects claims, enhance your coding standards for subsequent hospital visits
10/14/2019
by: Richard Scott
Tread carefully with your coding for subsequent hospital visits — 99231, 99232 and 99233 — because one of Medicare’s watchdogs is putting providers on alert that the services are linked to a raft of improper payments.
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