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New data: High-level E/Ms still growing, more new patient visits billed

09/19/2013

CMS’ 2012 E/M utilization and denial numbers are out. They show that utilization is still climbing, though not as much as in the previous year, and new patient codes are growing faster than established patient codes. But billing higher-level E/Ms comes with new risks — after a long decline, denial rates are rising again, and certain popular coding gambits may draw the scrutiny of CMS.

Cash-saving budgeting strategies go unused, survey shows

09/19/2013

by: Roy Edroso

A recent Part B News survey shows many practices skip basic budget functions that, if they were followed, would save practices money. Respondents were good about reviewing their basic finances, but they were less conscientious about using other budget tools; about half said they didn’t use financial dashboards, and only 35% said they did regular audits designed to track spending or collection patterns.

Ensure your EHR vendor’s readiness for dual compliance deadlines to avoid delays, penalties

09/19/2013

by: Jennifer Clampet

Find out now whether your electronic health records (EHR) vendor will be ready for ICD-10 and stage 2 meaningful use in 2014, or risk claim submission delays and penalties. Vendors will need to increase their available resources if they plan to roll out ICD-10 and stage 2 meaningful use update software at the same time, experts say.

New RAC issue: Drug screening claims face audit scrutiny

09/19/2013

by: Lauren C.Williams and Laura Evans

Your revenue is at risk if your practice regularly bills urine drug tests thanks to a new recovery auditor (RAC) target. HealthDataInsights, the RAC for Region D — Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming — is going after G0431 (High complexity test) and G0434 (CLIA-waived or moderate-complexity test) for excessive billing. In particular, HDI is concerned with billing the G-codes per drug that is tested.

Benchmark: Percent change in E/M utilization, 2011-2012

09/19/2013

by: Roy Edroso

In recent years, the number of claims with E/M new-patient codes (99201-99205) have been rising — particularly at Level 4 and Level 5, which grew by a whopping 157% and 193%, respectively between 2007 and 2011. Claims with established-patient codes, on the other hand, grew a little at the high end but actually declined for Levels 1, 2 and 3. New CMS data shows a few changes between 2011 and 2012.

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