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Value-based modifier cuts, bumps hit practices; focus on 2016 reporting

03/21/2016

The value-based modifier (VBM) program – a ramped-up version of the physician quality reporting system (PQRS) that scales payment to cost and quality measures – sunk its teeth into 59 practices this year, and those practices will see – pay cuts of as much as 2% for the rest of the year.

Hear, hear: 3 tips to successfully report new cerumen-removal code

03/21/2016

by: Richard Scott

The debut of cerumen-removal code 69209 gave practices a new avenue for reimbursement in 2016, but early indicators show you’ll need to pay close attention to the code’s strict reporting protocol, including modifier use, to ensure reimbursement.

Proposed enrollment rule will have practices rethinking relationships

03/21/2016

by: Julia Kyles

What’s the worst thing that could happen to a practice if one of its partners hasn’t refunded an overpayment to the state’s Medicaid program? Under the proposed enrollment rule released Feb. 25, the practice could have its application denied or revoked if it doesn’t report the debt during the enrollment or revalidation process.

Value-based modifier program tallies $79 million in payments, adjustments

03/21/2016

by: Richard Scott

Some practices are reaping 32% gains this year based on their performance in Medicare’s value-based modifier (VBM) program, according to data CMS released in early March

Add 3 key screenings to update your AWV form, secure revenue

03/14/2016

by: Roy Edroso

If you haven’t updated your annual wellness visit (AWV) form since the service first became billable in 2011, you actually don’t have to do too much beyond add some preventive services that can be billed with or initiated as part of the service.

CCI edits: Bill infusions with other services; watch endoscopy code bundles

03/14/2016

by: Richard Scott

You can bill intravenous infusion codes with just about any other service you perform, according to the latest quarterly coding edits from the National Correct Coding Initiative (CCI) released in February.

5 documentation errors that could cost you your home health certification fee

03/14/2016

by: Roy Edroso

Protect your payment for certifying home health services as CMS institutes a sweep of claims by avoiding these five common certification errors.

Diabetes training, E/M on same day OK if you bill with different NPIs

03/14/2016

by: Roy Edroso

Question: If a patient is receiving diabetic self-management training (DSMT), can they also receive an E/M service related to diabetes on the same day?

5 reasons to think twice about providing free treatment for employees

03/14/2016

by: Roy Edroso

If you want to provide free medical treatment as a perk to your employees, be careful to spell out the limits of the benefit up front.

Use of initial AWVs keep going down — but denial rates keep going up

03/14/2016

by: Roy Edroso

Denial rates for the initial annual wellness visit (AWV) are on the rise, which may help explain why their use is going down. Subsequent AWVs, however, are improving in both utilization and denials.

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