In six short weeks, you'll face dramatically different payments for many fee schedule services, with revised practice-expense relative value units (PE-RVUs) based partly on a controversial new dataset. Under the Physician Practice Information Survey (PPIS), PE-RVUs will increase or stay roughly the same for most specialties, but many codes frequently billed by specialties that provide the largest volumes of imaging services will see significant PE-RVU cuts.

You're in a tough spot when a private payer retroactively cancels a patient's coverage, then hits you up for money back on services already rendered. Before you just send the money back and try to bill the patient, use these proven strategies to minimize losses.

The House of Representatives narrowly passed a 1,990-page health reform bill Nov. 7. The massive bill contains several Medicare-related items impacting your bottom-line, but there was no room to address the 21.2% cut to Medicare rates beginning Jan. 1.

Download this month's tool, the DecisionHealth Professional Services Time Score Sheet, from the Part B News website, www.partbnews.com. This DecisionHealth Professional Services tool will help you determine the correct level of service to bill for six inpatient and outpatient E/M encounters. Print out this handy PDF and give it out to your billing staff to refer to when using time to code an E/M service.

You and your peers have had been losing money for the last four years thanks to denials for spine X-rays, a Part B News analysis shows. Denial rates for five relatively common spine X-ray codes range from 12% to 40% and have stayed flat at those high levels from 2005 to 2008, the analysis shows. Most importantly: more than 80% of the denials were billed in the office setting, according to a breakdown of the examined CMS claims data.

This chart shows you how much money you'll lose once consult codes are eliminated and those services replaced with a combination of new/established E/M office visit codes and initial hospital/nursing facility codes.

We're getting denials for a screening colonoscopy because the patient has a past history of polyps (V12.72). Is there a different code we can used to get this paid as a screening? The patient is reluctant to pay for the service out of pocket, despite concerns about colon cancer.

Providers will bill the appropriate initial hospital care code (99221-99223) in lieu of an inpatient consultation code (99251-99255) starting Jan. 1.