A broad range of specialties are billing more high-level new patient E/M codes, similar to a trend toward greater billing of high-level established E/M codes, according a Part B News analysis of CMS claims data (PBN 2/8/10). NOTE: The percentages above the bars show how much utilization growth codes 99204 and 99205 have seen over the three-year window.

This tool, developed by DecisionHealth Professional Services, will help you select the overall complexity of medical decision-making for a service by looking at the diagnosis (and/or management options), amount and complexity, and risk of complications or morbidity. You'll see it's as easy as 1-2-3!

The AMA issued a 10-page report to clarify how you use consultation codes 99241-99245 and 99251-99255 when billing the non-Medicare payers still accepting the codes. The guidance is too little, too late as far as CMS is concerned. The agency had complained that the rules for billing these codes were too confusing when it eliminated consults Jan. 1 (PBN 11/9/09).  But some private payers and Medicaid plans still pay for and want you to use consult codes.

You need to have a physician recruitment plan in place so you can quickly and efficiently bring a physician on board, whether you're looking to replace a retiring physician or hoping to open a satellite office in a neighboring town, experts say.

$44,000 in Medicare incentives (and thousands more in Medicaid and private payer incentives) available to your practice are riding on whidh electronic health record (EHR) system you select (see main story). Remember these four guidelines when you shop for an EHR system.

Electronic health records (EHRs) can be fully certified, but still lack the features needed to demonstrate meaningful use - costing you your share of $44,000 in Medicare incentive payments, as well as thousands more from Medicaid and private payers. Instead of making an EHR purchase based on its certification, base your decision on the vendor who's selling and maintaining it, experts say.

You could be staring at more denials for lack of medical necessity and costly repayments if you don't strengthen your documentation to meet stringent new requirements in the review criteria used in Medicare's latest Comprehensive Error Rate Test (CERT) program.

You would see another temporary reprieve from a 21% Medicare pay cut - this time for seven months - under a provision Senate lawmakers tucked into a jobs-creation bill. The move would push back to Oct. 1 a pay cut now set for March 1.  

You won't have to worry about major changes to the definition of "place of service" and "date of service" for the interpretation of diagnostic services anymore, Part B News has learned. CMS has decided to postpone the rule, which would've affected any physician performing the professional component (PC) of diagnostic tests in general and radiologists in particular.