These pie charts examine the five E/M codes used for established patient office visits, showing their respective percentage share of all established visit E/M utilization. We compare the utilization percentage of each code in 2000, 2007 and 2008; this long window shows a slow but steady shift to billing more high-level codes like 99214 and 99215.

I understand that 94760 (Pulse Ox., $2.89) is usually bundled into the patient visit. Can you give me an example of when we could bill for the service separately?

Only 18% of your peers report a significant increase in the number of patients with flu-like symptoms since Aug. 1, but three-fourths have already ordered a supply of the swine flu vaccine (see story), according to an unscientific Part B News reader survey.

You'll need to do more than just collect the nasal-spray doses of swine flu vaccines now en route to 25 states and spray your patients; different states have different requirements for practices that have requested the vaccine, Part B News has learned (see sidebar).

Allergy services were among the fastest-growing, most frequently denied codes from 2007 to 2008, according to a Part B News analysis of the latest CMS claims data. This chart lists 10 of the fastest-growing, high-denial codes, selected because each saw its utilization and denial rate increase from 2007 to 2008.

Start with CMS's guidance for IV hydration therapy (96360, $56.62) when you audit your claims. That's what your Recovery Audit Contractor (RAC) will use to determine whether you've received an overpayment for this service. The rule: "The hydration codes are used to report a hydration IV infusion which consists of a pre-packaged fluid and /or electrolytes (e.g., normal saline, D5-1/2 normal saline +30 mg EqKC1/liter) but are not used to report infusion of drugs or other substances."

Sure, you're eligible to receive incentive payments in 2010 for e-prescribing work you did in 2009 (PBN 12/8/08). But the HHS Office of Inspector General (OIG) sees a high chance of fraud or abuse, so it has put your practice on its radar to be sure you rightfully earned the money. Review of e-prescribing payments will help the OIG prepare for reviews of the even larger incentive payments that will be handed out in the future for implementing electronic medical records system (EMR), OIG writes in its just-released 2010 Work Plan.

You and your peers are billing more high-level established patient office visits than ever before, a shift upward from low and mid-level E/M codes, an exclusive Part B News analysis shows (see chart). The facts: 99214 (office/outpatient visit, est., $92.33) made up 30.9% of all claims submitted with codes in the 99211-99215 series in 2008 - dramatically up from 20.7% in 2000. 99214's increased share represents a numerical increase of 34.2 million claims submitted over the eight year window.

You'll need to start using two new enrollment forms by Nov. 30 or risk your application being denied by your carrier. CMS made mostly minor edits to the forms, but make sure you download and use the correct forms before you begin the time-consuming enrollment process. The changes apply to CMS-855I (for physicians and non-physicians) and CMS-855B (for medical groups and clinics).