Your best bet for getting bonus payments from Medicare’s Physician Quality Reporting System (PQRS) is through registry based reporting, a study shows. But in addition to getting paid for this year’s reporting, using a registry lessens your chances of getting penalized 1.5% in 2015 and 2% in 2016 for failing to report in 2013, a looming mandate for all Medicare providers.

Push your doctors to improve their E/M level selection, and you’ll see your revenue rise because of fewer denials from upcoding and fewer missed opportunities from downcoding. The varying and sometimes inconsistent interpretations by Medicare administrative contractors (MACs) about what documentation qualifies for E/M levels 1 through 5 make 100% accurate level selection impossible.

Your practice’s revenue is at risk if you haven’t performed internal audits on your E/M and procedure claims in the past year.

Pain management, orthopedic or spine practices must carefully read their carriers’ local coverage determinations (LCDs) to prevent denials on lumbar facet blockade procedures, percutaneous vertebroplasty and percutaneous vertebral augmentation (kyphoplasty) claims.

An electronic health record (EHR) subsidy from a health plan or other entity may work for your practice to help defray the cost of the systems. Blue Cross Blue Shield of North Carolina (BCBSNC), for example, has announced a $23 million initiative to provide EHRs to 750 of its participating physicians (PBN 4/2/12).

This chart shows the percentage of copays collected at the time of service for better-performing practices, based on the Medical Group Management Association’s (MGMA’s) Performance and Practices of Successful Medical Groups: 2011 Report.

Is 20670 (removal of implant; superficial, separate procedure) billable to Medicare – and payable – in the postoperative period? Some resources indicate that it is only appropriate for coding purposes but do not confirm whether it is billable and payable.