A top CMS official says you should have no doubts: come April 5, 2010, you will see rejections on any and all Part B services ordered or referred by physicians who are not in CMS's online Provider Enrollment Chain Ownership System (PECOS).

Your claims for the interpretation of a diagnostic service - the professional component - need to show the actual place of service (POS) and date of service (DOS) the physician read the results of a test or image, CMS says.

You now have two months before the 21.29% Medicare physician pay cut hits (see story), but don't wring your hands just yet: experts predict 2010 will be the year of the permanent pay fix. Even more profound will be the impact of a final health reform bill, which could become law at the end of January.

As we begin 2010, here's a look at how Part B News' predictions for 2009 turned out.

Ongoing health reform efforts in Congress should dominate your attention span because it promises to bring profound change to your practice. You're also concerned with last-ditch efforts to fix the more than 21% cut to Medicare payments staring you in the face. But these are not the only things you need to be aware of to bill successfully in 2010.

For many high-utilization codes, it's deletions in the latest set of Correct Coding Initiative (CCI) edits that have the most impact, according to a Part B News analysis of CMS claims data from 2008 and changes in CCI version 16.0, in effect since Jan. 1 (PBN 12/21/09).

CMS will ring in the New Year with a temporary payment hold on your claims. According to a CMS list-serve notice issued Dec. 21, carriers will hold claims for ten business days (Jan. 1 to Jan. 15, 2010). CMS is taking this step to avoid the confusion that has resulted when Congress passed a pay fix soon after the start of the year and carriers had to reprocess all of the claims that were submitted in the interim.

There's good news and bad news for your drug billing as 2010 kicks off. Aggregate payments for the top 50 drugs billed to Medicare are expected to dip by 1.1%, although more individual drug codes will see boosts than cuts in the first quarter of 2010 under Medicare's average sales price (ASP) +6% payment system.

When we submit a claim with modifier 53 (discontinued procedure), our carrier holds our payment until we provide additional information on why the procedure was discontinued. According to the carrier, we can put the information in Box 19 on the claim form to avoid the delay. My question is, what information should I include that will satisfy the carrier, avoid a delay and fit within the space allotted for that box?