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Find the right partners to make virtual groups for MIPS worth it for your practice

09/10/2018

You have until the end of the year to sign up for Merit-based Incentive Payment System (MIPS) virtual groups, and teaming up with complementary providers may help you get better scores more easily.

Proposed 50% markdown on E/M+25 scenarios means losses for common combos

09/10/2018

by: Roy Edroso

CMS’ plan in the proposed 2019 Medicare physician fee schedule to cut either a E/M charge or a procedure charge when modifier 25 is used would, if finalized, require some billing changes – and result in varying degrees of loss -- in common scenarios.

AHRQ offers free forms to get patients to write down their questions

09/10/2018

by: Roy Edroso

Part B News is always happy to wind up on the same wavelength as HHS' Agency for Healthcare Research and Quality (AHRQ), especially when it comes to hot ideas for improving patient care.

Excluded RN costs practice $61,000

09/10/2018

by: Marla Durben Hirsch

William H. Newman, M.D., and Allergy & Asthma Specialists of Northern Vermont, P.C., agreed to pay a $61,142.96 settlement to the HHS Office of Inspector General (OIG) on July 2.

View a patient’s pic? Under CMS proposal, you can get paid for that

08/27/2018

by: Richard Scott

CMS is amping up its tech-based coverage policies, and you’ll find a suite of new ways – assessing images, taking phone calls and more – to get paid in 2019 should the proposals get finalized. However, experts caution that some of the glitter may fade when you dive into the details of the services.

Losing touch with patients as you grow? Try these high-touch tricks to reconnect

08/27/2018

by: Roy Edroso

A study suggests large practices actually underperform small practices in cost of care and hospital readmissions, but you might redress the balance by engaging independent networks, educating your patients and using your imagination.

Nowhere to hide: Proposed rule would kill risk-free path to shared savings

08/27/2018

by: Roy Edroso

A proposed Shared Savings rule pushes risk onto all participants within a few years – and signals more risk in the future for all Medicare providers as well.

Supreme Court nominee likely pro-business, skeptical of government

08/27/2018

by: Angela Childers

With the upcoming vetting of Brett Kavanaugh for the soon-to-be vacant seat of Justice Anthony Kennedy on the U.S. Supreme Court, providers may see a pro-business ally whose past rulings show a skepticism of the power of administrative agencies.

Double-check critical care services reported with modifier 25

08/27/2018

by: Julia Kyles, CPC

Practices that bill for critical care services (99291-99292) should make sure everyone understands the coding rules for these high-value codes, as well as the use of modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) with critical care services. The combination of critical care and modifier 25 is on auditor radar and could trigger denials.

Promoting Interoperability hardship exception application opens; keep receipts

08/20/2018

by: Roy Edroso

The hardship exception application for the merit-based incentive payment system’s (MIPS’) Promoting Interoperability category, which opened Aug. 6, is simple to complete, but make sure you’ve got the goods to justify your case in case CMS decides to audit your claim.

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