Part B News | Part B News

With E/M denials rising, avoid these 3 coding myths to stay afloat

10/03/2013

There’s a lot of misinformation out there about even the most common diagnoses and code sets. With the latest CMS data showing denials rising for higher-level E/M codes, make sure you don’t lose time or money by succumbing to these common myths. For example, some believe that if a doctor changes practices or specialties, the three-year clock gets restarted -- but this is untrue.

CMS: Shutdown won’t stop Medicare payments or enrollment, for now

10/03/2013

by: Grant Huang

You won’t have to worry about your Medicare payments being frozen as a result of the federal government being shut down starting Oct. 1. Fortunately, all Medicare Administrative Contractors (MACs) will continue normal functions during the shutdown, including the processing and payment of fee-for-service claims. However, the fate of other CMS activities remains uncertain.

Practices race the clock to get ready for ICD-10, but have concerns about productivity, vendors

10/03/2013

by: Scott Kraft

The next six months are when most physician practices expect to determine what they need to do to be ready for ICD-10 implementation on Oct. 1, 2014, followed by taking the necessary training and testing steps, according to a recent Part B News survey. While only about 6% of respondents said that they’re not preparing for ICD-10 because they believe it will be delayed again, close to 25% say they don’t believe they’ll be ready in time.

Avoid denied claims by using tools to verify patients’ insurance eligibility

10/03/2013

by: Karen Long

Check the insurance eligibility of your patients two to three days before their appointments to ensure proper billing and collections and to reduce the expense it takes your practice to fix delayed or denied claims. It could save your practice up to $3.32 per claim that it would cost to rework those claims. It's easier than ever thanks to a health reform provision that requires health plans to provide eligibility verification within 20 seconds.

5 steps to stop private payers from passing sequestration cuts to you

10/03/2013

by: Marla Durben Hirsch

You have no choice but to accept the automatic across-the-board sequestration 2% budget cuts to your Medicare fee-for-service claims that went into effect April 1. But many private payers have been using it as an excuse to reduce providers’ reimbursements with whom they have contracted, even though providers may not have to comply.

Benchmark: Denial rates for new patient visits by provider type, 2011 vs. 2012

10/03/2013

by: Grant Huang

The more you do something, the better you are it. This old truism certainly seems to apply to new patient E/M codes. We looked at the denial rates of new patient visits for specialists in 2011 and 2012, and compared them to denial rates for primary care physicians in the same period. The results are striking: On average, primary care gets denied twice as much as specialists for codes 99201-99205.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.