Part B News
04/01/2019
Denial rates for the most popular screening and counseling codes for depression and alcohol and substance abuse are not great, and in one case forbidding. Make sure you get the little things right on your claims.
03/25/2019

In recent months, CMS has made a play at revamping how E/M services are documented and paid for, and the AMA is working in earnest on a rebuttal. Now the Medicare Payment Advisory Commission (MedPAC) is weighing in on the debate and urging lawmakers to be careful about the value attached to E/M codes.

03/25/2019
Private health insurers are getting aggressive about auditing providers and prosecuting what they see as fraud — and you should take any communication from them on that score very seriously.
03/25/2019
A sudden shortfall in Blue Cross Blue Shield (BCBS)Vermont payments, and the trouble it’s causing some small practices, is a reminder that you should have a financial cushion for your practice in case of emergencies — and make sure to keep it up to date.
03/25/2019

Question: My pain management practice is using two forms of risk assessment questioning for our pain management patients -- one cpmputer-based, one on paper. However, the 2019 codes are completely different tham what we were using. How do we code them now?

03/25/2019

Various specialties tend to generate different amounts of work relative value units (RVUs) under CMS’ current pricing system, and those differences are tied to payment chasms, a March 15 report from the Medicare Payment Advisory Commission (MedPAC) states.

03/18/2019
Question: My pain management practice is using two forms of risk assessment questioning for our pain management patients. One is computer-based with staff assistance. The other is done on paper and interpreted by the provider. We were using 96103 (Psychological testing [includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, MMPI], administered by a computer, with qualified health care professional interpretation and report) for the computerized risk assessment. However, the 2019 codes are completely different. Can we code 96146 (Psychological or neuropsychological test administration, with single automated, standardized instrument via electronic platform, with automated result only) for the automated testing and scoring and 96160 (Administration of patient-focused health risk assessment instrument [eg, health hazard appraisal] with scoring and documentation, per standardized instrument) for the paper risk assessment that is scored by the provider?
03/18/2019
Take a deep cut into the Correct Coding Initiative (CCI) version 25.1 edits and you’ll glean several hundred pending code bundles that will wrap up various lesion-removal services as well as a wholesale update to a single irrigation-of-device code.
03/18/2019
Gaps in mobile security remain a threat to your protected health information (PHI) and leave you vulnerable to HIPAA violations, so train and, if necessary, restrain employees to reduce the risk.
03/18/2019
Electronic aids that review what’s in a patient’s electronic health record (EHR) and give prompts for how to code for the services can be useful. But if you blindly follow those suggestions you can end up billing incorrectly and in legal hot water.

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