Part B News | Part B News

MACs team up on national urine drug test policy ‘that will shock some people’

11/07/2022

If your practice orders or performs urine drug tests (UDT), take note: Your Medicare administrative contractor (MAC) is working on a new policy for these high-utilization services, and it could go into effect in the next few months.

AMA alerts practices to hidden E/M pay cuts by private payers

11/07/2022

by: Julia Kyles, CPC

Watch your payers’ communications and your remittance advice codes for signs of stealth pay cuts and automatic downcoding, the AMA warns in a 15-page guide the association announced in an email Oct. 21.

CDC loosens up on masks; whether you agree or not, set a clear policy

11/07/2022

by: Roy Edroso

Recent CDC guidance suggests some added flexibility in mask use in medical facilities. If the guidance doesn’t track with your own masking policy, make sure your staff and patients are clear as to where you stand.

New vaccine mandate guidance goes easier, but 100% is still the goal

11/07/2022

by: Roy Edroso

In a revision to its previous guidance on the health worker vaccine mandate, CMS still holds that any less-than-100% compliance is noncompliance but suggests that good-faith efforts may merit a reprieve.

Tips to start the journey to outpatient and ambulatory CDI

11/07/2022

by: Jennifer Boles

Many health care systems are looking at where to expand next in the outpatient and ambulatory medical group settings. Outpatient clinical documentation integrity (CDI) is often focused on hospital emergency department (ED) and observation settings. Ambulatory CDI is viewed as provider-billed charges and focuses on medical group clinics.

Part B claims in 2021 inched up, but payment surged

11/07/2022

by: Roy Edroso

After stalled growth in 2020, practices lived through a modest recovery in utilization in 2021. For payments, however, it was a banner year.

As practice burnout boils over, take bold steps to hold and head it off

10/31/2022

by: Roy Edroso

Even as pandemic pressures fade, symptoms of burnout in medical providers are getting worse rather than better, recent findings show. Practices that want to stem the tide should take advantage of tested methods and metrics — as well as some more imaginative ones — to help hold the line.

CMS seeks comment on payer-agnostic data directory with potential provider savings

10/31/2022

by: Roy Edroso

A request for information (RFI) for a payer-agnostic provider directory is a sign that CMS is pushing harder for an interoperability standard in health care data exchange that also will include private payers.

Let the reason for the encounter drive coding for ED visits

10/31/2022

by: Julia Kyles, CPC

Question: How do you report emergency department visits by a provider who is not on the emergency department staff?

Virtual incident-to visits are still a choice during COVID-19 PHE

10/31/2022

by: Julia Kyles, CPC

Question: We conducted a sample review of claims for 2021 and found two visits that were performed by the physician assistant (PA) but billed incident-to on days when the physician was not in the office. When we investigated, we found more claims with the same problem. According to the documentation for each visit the physician was at home but “present” through a real-time, audio/visual Zoom connection. Is there an exception that allows us to bill incident-to this way?

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