Part B News
Listen to needs, try appeals to payers when prices keep patients from meds
12/03/2018
by: Roy Edroso

New studies show a disturbing number of patients abandoning prescriptions they can’t afford, but a little extra effort on your part — including patient outreach and an appeal letter to the insurer — might help some of your patients get a second chance.

Practices must add opioid review during Medicare’s AWV and IPPE encounters
12/03/2018
by: Richard Scott

Ensure your providers are reviewing a patient’s use of opioids during encounters for the initial preventive physical examination (IPPE) and annual wellness visit (AWV) codes or you’ll face the threat of a denial, according to updated Medicare guidance.

Top 10 winners and losers of the 2019 Medicare fee schedule
12/03/2018
by: Richard Scott

Now that the scores are in, you can assess the winners and losers of the final 2019 Medicare physician fee schedule, which increased the payment rates of some oft-used codes and slashed rates on others.

From the Part B News blog
12/03/2018

Take note of the news that happens between Part B News issues by checking out the free Part B News blog. Here’s a sampling from this week:

E/M on the horizon: Payment, coding, documentation changes to come
11/19/2018
by: Richard Scott
Wait for it: CMS cued the music then placed its earth-shifting E/M changes on hold for two years. The earliest that medical practices will have to brace for a raft of payment and documentation revisions is Jan. 1, 2021, according to the final 2019 Medicare physician fee schedule released Nov. 1.
Medicare Advantage rule pushes telehealth boundaries past originating site specs
11/19/2018
by: Roy Edroso

The highlight of a new Medicare Advantage (MA) proposed rule is a plan to let MA insurers cover telehealth services without meeting the geographical and originating site requirements currently mandated for Medicare coverage.

Experts: Blue wave drowns GOP agenda in Congress – but some compromise is possible
11/19/2018
by: Roy Edroso

As you might expect now that the Democrats have taken control of the House, health policy experts predict gridlock will slow legislative action on national health care policy. But expect the administration to stay busy — and maybe get busier — in the regulatory arena in ways that will affect you and your patients.

MRI coverage expands to patients with implantable cardiac devices
11/19/2018
by: Richard Scott

Don’t let patients’ implantable cardiac devices, such as a pacemaker, stop you from ordering MRI tests. Under new rules, CMS has broadened its coverage terms to include such imaging services for patients with implanted devices, and you should iron out several new wrinkles to get your claims through.

MRI codes an easy pass — unless you miss policy changes
11/19/2018
by: Roy Edroso

Denial rates for codes related to magnetic resonance imaging (MRI) under Medicare are not terrible, but watch out for a few high-rejection codes and make sure you’re keeping up on CMS and contractor news and changes on the ones you use.

From the Part B News blog
11/19/2018
by: Richard Scott
Take note of the news that happens between Part B News issues by checking out the free Part B News blog at https://pbn.decisionhealth.com/Blogs/default.aspx. Here’s a sampling from this week.
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