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Next-generation genetic cancer test gets NCD; for advanced cancer patients only

04/09/2018

CMS has cleared a new genetic cancer test for Medicare patients – but be aware that it’s not for every patient, or even every cancer patient.

Your practice must accommodate service dogs — within reason

04/09/2018

by: Roy Edroso

Question: I saw a story in the news about a Nashville, Tenn., woman who was suing her doctor’s office for not allowing her service dog, who helps with her post-traumatic stress and obsessive-compulsive disorders, to accompany her on her doctor’s visit. Do practices have to accommodate service animals? What if they’re aggressive or the other patients in the waiting room are allergic?

Physical therapy claims rise, denials fall over recent three-year period

04/09/2018

by: Richard Scott

The most frequently reported physical therapy code, 97110 (Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility), topped $1.1 billion in payments in 2016, the latest year of available Medicare claims data.

From the Part B News blog

04/05/2018

Take note of the news that happens between Part B News issues by checking out the free Part B News blog at https://pbn.decisionhealth.com/Blogs/default.aspx. Here’s a sampling from this week.

Medical practice pros urge CMS to streamline E/M reporting, boost MDM

04/02/2018

by: Richard Scott

Physicians and medical practice advocates called on CMS to simplify the current E/M documentation guidelines during a March 21 listening session that the agency convened to gather feedback from professionals who work with E/M reporting on a routine basis.

Foot-dragging on Stark reform leaves APMs at risk, slows growth of program

04/02/2018

by: Roy Edroso

Congressional foot-dragging on reform of Stark and other fraud-and-abuse laws may leave providers in alternative payment models (APMs) subject to penalties even if they’re acting in good faith — which may be making the program too difficult for all but the richest entrants to attempt.

Understand payer tendencies, create a path of least resistance for prior authorizations

04/02/2018

by: Richard Scott

Tame the process for gaining prior authorizations to limit the amount of administrative burden you face and you may free up significant staff time and even improve patient care.

Prepare to defend inpatient TKA in face of payer, hospital pressure

04/02/2018

by: Laura Evans

Orthopedic practices: Don’t be caught off-guard if hospitals compel you to schedule total knee replacements in the outpatient hospital setting this year. Medicare removed total knee arthroplasty (TKA) code 27447 from the inpatient-only list, opening the door for providers to perform the procedures in the outpatient setting.

AMA docs: Prior authorizations can be lengthy, often impact care

04/02/2018

by: Roy Edroso

An AMA survey of 1,000 practicing physicians finds that prior authorization for medical services isn’t just annoying for them — it’s possibly a net loss for their patients’ health.

Add practice revenue, get a leg up on MIPS by wrapping in CCM services

03/26/2018

by: Richard Scott

Enrolling patients in a chronic care management (CCM) program can cut back on total health spending while adding revenue to your practice, resulting in a win for your bottom line that also positions you to perform well under quality-reporting and value-based programs.

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