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Look beyond fee schedule to understand proper injection supervision rules

12/19/2016

Question: What are the levels of supervision required for phlebotomy, injections or other services of medical assistants and nurses in the office setting? Please list source or link to the Medicare fee schedule database that you reference in your article.

Warning: HHS warns of HIPAA-related email phishing scam

12/19/2016

by: Richard Scott

Be careful before you open what appears to be a routine email related to HIPAA auditing because it may be a cleverly disguised scam email, warns HHS.

Watch common codes with double-digit denial rates when used with modifier 59

12/19/2016

by: Roy Edroso

Most codes that are frequently used with modifier 59 (Distinct separate service) have reasonable denial rates, but watch out for a few that seem to give providers trouble.

CCI update: Be wary of modifier 59, cerumen removal, other coding pitfalls

12/12/2016

by: Richard Scott

Audiologists should exercise caution when reporting lower-level cerumen-removal code 69209, and physicians delivering pulmonary services should heed episode-of-care guidelines, instructs the 2017 update to the National Correct Coding Initiative’s (CCI) policy manual.

21st Century Cures Act can bring your practice more money, breaks on MIPS, more

12/12/2016

by: Roy Edroso

All but certain to become law this month, the 21st Century Cures Act makes regulatory and financial changes that could have a direct impact on your practice in terms of merit-based incentive payment (MIPS) compliance, electronic health record (EHR) interoperability and even financial grants from HHS.

CCI update: Be wary of modifier 59, cerumen removal, other coding pitfalls

12/12/2016

by: Richard Scott

Out-of-network doctors’ obligations grow under state ‘surprise billing’ laws

12/12/2016

by: Marla Durben Hirsch

When you aren't contracted with a particular insurer, be prepared to disclose that fact to patients before you treat them. States are beginning to enact laws against “surprise billing” by requiring doctors to be up front about their out-of-network status and providing patients with cost estimates.

2017 OIG Work Plan adds E/M, financial relationships to the watch list

12/12/2016

by: Julia Kyles

Providers who offer chronic or transitional care management services should take note of the latest Work Plan from the HHS Office of Inspector General (OIG). These services are two of the six new Work Plan targets that are likely to impact physicians and non-physician providers who bill Medicare Part B.

Temporary injunction stops Labor’s OT rule from taking effect nationwide Dec. 1

12/12/2016

by: Josh Poltilove

Practices that already increased employees’ salaries to avoid a new federal requirement to pay them overtime beginning Dec. 1 should examine whether that decision still makes sense.

New hospitalist specialty code debuts in April

12/12/2016

by: Roy Edroso

Watch out for a new specialty code for hospitalists going online for dates of service on or after April 1, 2017.

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