Part B News | Part B News

Breach alert: If ransomware hits, consider the pros and cons of paying the ransom

07/01/2019

Though it’s been in the news for years, ransomware and related cyber exploits have not been contained. Your best bet is to keep or step up your diligence but also decide whether you’re willing to pay the cybercrooks to get your data back — and, if so, to prepare for it.

Bipartisan bill takes aim at unruly prior authorizations, seeks real-time approvals

07/01/2019

by: Richard Scott

Practices that dread the time lags and course-of-care disruptions that result from prior authorizations gained good news as momentum builds behind legislation aimed at streamlining these types of approvals.

As audits spike, stick to medical necessity, bundling rules for 99291-99292 claims

07/01/2019

by: Richard Scott

Watch out for federal auditors clamping down on critical care coding and double down on medical necessity to secure you’re in the clear for these oft-used services.

To avoid denials, ensure CCM initiating visit code G0506 goes beyond norm

07/01/2019

by: Richard Scott

Question: I’m seeing a lot of denials on my initiating visit claims for chronic care management (CCM) services. Is that because I’m reporting the CCM code with a routine E/M code? Do I need to wait for a specific date to bill? Please help!

Prior authorizations causing many patients to abandon the plan of care, survey shows

07/01/2019

by: Richard Scott

The regulatory burden linked to prior authorizations is getting worse, and it’s not only causing administrative headaches. It’s also leading to patients veering from the recommended course of treatment.

Want to banish burdens? Air your grievances, propose ideas to CMS now

06/24/2019

by: Richard Scott

If you want to diminish the red tape you must cut through when participating in federal health care programs, you have until Aug. 12 to let CMS know what it can do to ease your administrative hurdles, such as onerous documentation.

Heed employee charges of patient harassment — but be careful about banning the patient

06/24/2019

by: Roy Edroso

Physician practices have a duty to protect their employees from sexual harassment by patients with clear reporting procedures and follow-through. But you may want to consider your options before telling the accused patient not to come back for treatment.

Claiming modifier 22? Make sure it’s extra work, then make your case

06/24/2019

by: Roy Edroso

Question: Our surgeon performed an acetabular fracture (27254) and it took him a great deal longer than usual owing to the patient’s obesity. He wants to use modifier 22 (Increased procedural services) to be paid for the extra time. What do we have to give CMS to get that paid?

Big operations (total knee, shoulder) do well with 22, but what’s with the heat lamp?

06/24/2019

by: Roy Edroso

Modifier 22 (Increased procedural services) doesn't get claimed a lot. But on some of procedures for which it’s most often used — the ones for which you can easily see how extra work would be required — it has low denial rates. And there are some codes with 22 for which you have to wonder what the billers were thinking.

Veterans get more non-VA health access via practices, urgent care

06/24/2019

by: Roy Edroso

The U.S. Department of Veterans Affairs (VA) has issued a pair of rules offering people who have served in the U.S. military opportunities for covered health care outside the 1,255 health care facilities specifically designated for veterans.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.