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01/02/2017

Check out how Part B News and its experts fared with the 2016 predictions:

01/02/2017

CMS rolled out a final rule Dec. 20 outlining three new cardiac care models and one new orthopedic care model to start as early as July 1 as well as one new small-practice-friendly accountable care organization (ACO) track to start in 2018.

01/02/2017

Question: A patient of a multispecialty group practice came in to see an internist. She reported herself pregnant — though this had not been medically confirmed... a few weeks later, the pregnancy was confirmed on a visit to our OB... Can the practice use the pregnancy O codes on the first visit, even though they plan to bill the confirmation code Z32.01 for the later ob/gyn visit?

01/02/2017

Question: Medicare denied 77002 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]) when our ambulatory surgery center reported it with 20610 (Arthrocentesis, aspiration and/or injection, major joint or bursa [e.g., shoulder, hip, knee, subacromial bursa]; without ultrasound guidance). Can you explain why we’re getting this denial?

01/02/2017

The competition for a limited amount of incentive dollars tied to the merit-based incentive payment system (MIPS) may be fierce in 2017, as nearly two in five respondents to a recent medical practice survey said they would report multiple measures during the 2017 transition year.

12/19/2016
A new year means new patient deductibles — some of them enormous. And if you wait until January to get ready for patients with unmet deductibles, you’ll take a cashflow hit.
12/19/2016
Don’t panic if you discover the Oct. 1 roll out of new and revised diagnosis codes triggered quality reporting bloopers for one or more providers at your practice. CMS announced in a Dec. 13 email that it will cut those providers a break.
12/19/2016

It’s now more important than ever for physicians to check what pharmaceutical and medical device manufacturers have reported about payments made to them. The HHS Office of Inspector General (OIG) has decided that those payments warrant further scrutiny and has added it as a new topic of investigation to its 2017 Work Plan.

12/19/2016
Hospital billing offices should be careful when reporting claims for stem cell transplants involving CPT codes 38240 and 38241 because many are billed under inpatient status when they should really go to Medicare administrative contractors (MACs) under Part B.
12/19/2016
Question: A lawyer told us that when “shall” appears in official guidance, it means “must.” For example, because the CPT manual says that when counseling and/or coordination of care is more than 50% of an encounter, “time shall be considered the key or controlling factor to qualify for a particular level of E/M services….” He says that means we have to bill based on time for those encounters. Is he right?

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