You'll face some big new changes when it comes to immunization billing in 2011, thanks to new codes that will affect both your older patients on the Medicare side and your pediatric patients on the private-payer side.

Your work is cut out for you when it comes to wound care coding in 2011, thanks to CPT changes aimed at making debridement services easier to bill. There are code deletions, new add-on codes and new documentation requirements, experts say.

You will face the latest set of Correct Coding Initiative (CCI) edits when you return to work on Jan. 3. CCI version 17.0 technically takes effect Jan. 1, but Jan. 3 is the first business day of 2011. This newest round of edits contains a total of 29,600 changes, up from the 19,702 changes in CCI version 16.3 (PBN 9/27/10), a Part B  News analysis shows.

The latest version of the Correct Coding Initiative (CCI) edits (version 17.0) brings 19,595 new code pairs, deletes 9,559, and includes significantly more mutually exclusive additions and deletions than version 16.3. Check out the official Part B News CCI Scorecard for a complete breakdown.

Your practice can see patients more quickly while making fewer paperwork errors using online, electronic patient registration tools, a growing technological trend that will boost your bottom line, practice managers say. Caveat: These services aren't free and come with a learning curve both for your staff and patients, which could slow you down at least temporarily when your existing paper-based system already works well.

Expect to see physician involvement during medical necessity reviews conducted by Medicare Advantage (MA) plans, thanks to a new requirement proposed by CMS. This would prevent MA plan officials without direct knowledge of providing medical care from making unfavorable decisions when auditing your claims.

Summary: This chart compares the denial rates for new and established office visits, levels 3 to 5, by specialty based on the latest CMS claims data from 2009. These specialties were chosen to cover a diverse array of practices. NOTE: Data labels indicate the actual denial rate for the level 3 and level 5, omitting level 4.

This week's question is answered by Regan Bode, CPC, CPC-H, CPMA, CEMC, ACS-EM, content manager for DecisionHealth and consultant for DecisionHealth Professional Services.

Q. It is my understanding you can bill a separate procedure during a non-covered [preventive care service] (99381-99397). Can the additional procedure be a visit such as a 99213? Which codes would get the 25 modifier?

Your non-physician practitioners (NPPs) can play a huge role in helping your practice and patients reap the full benefits of Medicare's new annual wellness visit (AWV), experts tell NPP Report. Not only does the final 2011 Physician Fee Schedule allow NPPs to furnish the annual wellness visit, it also allows them to bill this new service incident to, without the physician needing to be in the same room.