Home | News & Analysis
Part B News
Reserve modifier FT for surgeon’s critical care unless your MAC says otherwise
02/28/2022
by: Julia Kyles, CPC
From Medicare’s first announcement that it would create a new modifier for critical care services during an unrelated procedure’s global surgical period, modifier FT has been a source of confusion. Practices in many states are still waiting for detailed, official guidance from their Medicare administrative contractors (MAC), including which provider is eligible to report it.
Turmoil over Direct Contracting model has CMS mulling changes
02/28/2022
by: Roy Edroso
Rumblings in Washington threaten CMS’ Global and Professional Direct Contracting (GPDC) model, generally known as Direct Contracting. Experts expect the program to survive the challenge, but possibly with alterations to appease stakeholders who find the current model too friendly to large non-provider organizations.
Time to reevaluate how we evaluate coding performance
02/28/2022
by: Lawrence A. Allen, MBA, CPC, CPMA, CEMA
Over the past 25 years, medical coding has grown more critical to the success of an organization’s health care revenue cycle. Qualified coding professionals continue to be in high demand, despite the proliferation of electronic health records (EHR) and associated billing systems. Given the importance of this function, evaluating coders’ performance is an essential task for revenue integrity. The question is — is it time to reevaluate how we evaluate performance?
CMS make hundreds of CCI edit fixes in mid-quarter update
02/28/2022
by: Laura Evans, CPC
CMS has posted an unscheduled mid-quarter update to its National Correct Coding Initiative (CCI) procedure-to-procedure (PTP) claims edits. The change, with a posting date of Feb. 4, 2022, comprises reissued PTP edit files for both hospitals and practitioners.
Beyond E/M: NPs, PAs regularly clock blood draws, AWVs, skin procedures
02/28/2022
by: Roy Edroso
The increased Medicare billing of the leading non-physician providers – nurse practitioners (NP) and physician associates (PA) – is buoyed by E/M claims, given that these practitioners have become a major part of patient intake in practices. But their share of procedure codes also is increasing.
Outpatient remdesivir rolls out, and practices can offer and claim for it
02/21/2022
by: Roy Edroso
The monoclonal antibody treatment Veklury (remdesivir) is now available to use beyond the hospital setting. Check your local Medicare administrative contractor (MAC) for coverage rules and be prepared to meet the administration standards if you want to offer it to your patients.
Use a prolonged service decision tree to save time selecting prolonged service codes
02/21/2022
by: Julia Kyles, CPC
Your CPT manual contains four add-on code sets that allow your practice to earn additional revenue when a face-to-face (F2F) E/M visit in the office, outpatient or facility setting requires more time than usual.
Watch enforcement concerns after new challenge to vaccine mandate
02/21/2022
by: Roy Edroso
An amended complaint backed by more than a dozen states is seeking to overturn the Supreme Court’s ruling on the vaccine mandate for health care staffers and, while experts consider it a long shot, it could delay broader enforcement.
Refresh your understanding of CPT coding for radiology services
02/21/2022
by: Sarah Gould, CPC
From diagnostic radiology to bone and joint studies, the expansive field of radiology services — predominantly spanning the 70000 CPT series — contains many commonly used codes. Assess the latest radiology updates, including 2022 changes, to keep your claims reporting up to date.
Make sure your provider is the last one to sign the note
02/21/2022
by: Roy Edroso
Question: At our practice, the billers are often the ones to close the doctor’s note. While we read through the note for coding, we also correct spelling and make other staff aware of missing documentation or orders. We sign and date along with the doctor’s signature and date. Is this OK? Also, if our physician assistants are rendering providers and we bill under our surgeon’s national provider identifier (NPI), do both the physician assistant (PA) and the surgeon need to sign the note?
Prev Next

Login

User Name:
Password:
Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Quick Links
Learning Opportunities
See more...
Forum

The Forum is temporarily unavailable.

click icon to expand
Back to top
Privacy Policy
|
Terms of Use
|
© 2026 DecisionHealth, an HCPro Brand