Part B News | Part B News

As MIPS, practice hassles get harder, pay-for-performance gets more attractive

09/09/2019

Discouraging bonuses and ever-increasing requirements under the Merit-based Incentive Payment System (MIPS), along with other hassles of modern fee-for-service life, may be driving some providers out of business — or into new payment models, where CMS would prefer to see them.

2021 payment preview: Charges up 16% for some specialties, down 10% for others

09/09/2019

by: Richard Scott

The major modifications that CMS has proposed for oft-reported E/M office codes 99202-99215 would bring disruption to your documentation standards – but not only that. Depending on your specialty, the changes could substantially move the needle on your revenue stream.

Look for these traits when hiring a clinical documentation improvement specialist

09/09/2019

by: James Dresbach

Wanted: An accurate, intelligant, prompt, high-quality self-starter to provide a high level of service during the entire medical coding process.

No, it’s not $6.50: Charge for patient records based on facts, what’s reasonable

09/09/2019

by: Roy Edroso

Question: I’ve heard that we can’t charge a patient more than $6.50 to provide a copy of medical records on a patient request. Is that true?

Ophthalmology, endocrinology on opposite ends of 2021 E/M pay calculations

09/09/2019

by: Roy Edroso

In the recent proposed physician fee schedule, CMS estimated how fee changes would affect various specialties in 2020. But CMS also ran the numbers on the proposed changes to E/M code reimbursement, and how they would affect specialties when those changes are expected to take effect in 2021. It turns out they’ll help some specialties more than others — and leave some even worse off than before.

Correct Coding Initiative version 25.3 edits

09/06/2019

by: DecisionHealth staff

The Correct Coding Initiative (CCI) version 25.3 edits, effective Oct. 1, 2019, bundle dozens of codes that will restrict a range of same-day services, including some allograft procedures.

Proposed 2020 Medicare physician fee schedule

08/27/2019

by: DecisionHealth staff

This major proposed rule addresses changes to the physician fee schedule (PFS); other changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute.

Use liaisons, auto-referrals to get patients to cardiac rehab, other follow-up care

08/26/2019

by: Roy Edroso

Having trouble getting patients to do difficult follow-up therapies? Cardiac rehabilitation participation rates remain generally low in the U.S., but you can implement some methods that have been proven to raise them — and may also be applied to other rehabs as well.

Practices lob dire warnings to CMS ahead of planned cuts to cataract surgery

08/26/2019

by: Richard Scott

Many providers and medical groups are expressing dismay at the rate cuts expected to hit two frequently billed codes for cataract surgery in 2020, warning that sharp pay declines could harm patient care and break the bank, particularly in rural areas.

Prepare to expand list of who can document the record, and who must verify

08/26/2019

by: James Dresbach

You’re on pace to find significant adjustments to the medical record documentation review and verification process heading into 2020, as CMS seeks to curtail work burden associated with its reigning documentation standards.

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