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M&A outlook: More big deals; insurers, private equity stepping in

01/04/2016

Mergers-and-acquisition experts predict that the recent buying spree in the health care industry will continue and perhaps accelerate in 2016, with some new players joining the hunt and specialties getting fresh attention.

Congress eases way for providers to obtain meaningful use hardship exception

01/04/2016

by: Richard Scott

The Patient Access and Medicare Protection Act would give meaningful users a break; will Obama sign?

Modifier 25 denial rates hold steady for most heavy hitters

01/04/2016

by: Richard Scott

You’re losing out on big money if your notes supporting the use of modifier 25 (Significant, separately identifiable E/M services) are not up to snuff.

Case study part 2: Overcome operational challenges to succeed as a medical home

12/21/2015

by: Richard Scott

After you’ve taken the leap to become a patient-centered medical home (PCMH), keep an eye on ways to continually fine-tune your workflow — particularly around shared resources such as care management — to elicit long-term success.

Protect your practice, don’t overexplain when voluntarily repaying overpayments

12/21/2015

by: Roy Edroso

If you’ve discovered a Medicare overpayment and want to return it, be careful to pick the least suspicious accurate reason code and pay attention to details — especially the date.

New cerumen impaction removal code could add extra payment, confusion

12/21/2015

by: Scott Kraft

You’ll have a new CPT code to bill for removing impacted cerumen via lavage or irrigation — services that currently are considered part of the appropriate problem-focused E/M service. The new code, 69209, brings a new payment opportunity but also potential documentation pitfalls, experts tell Part B News.

NPPs doubling as scribes: Legal but not cost-effective; experts say it’s a waste

12/21/2015

by: Roy Edroso

Question: Can non-physician practitioners (NPPs) serve as scribes?

Flexibilities reduce denials and cash flow, but details point to problems

12/21/2015

by: Julia Kyles, CPC-A

To reduce the negative impact of the ICD-10 transition, CMS announced on July 6 that it would allow a certain amount of leeway on ICD-10 coding (PBN 7/13/15). Respondents to Part B News’ November ICD-10 survey believe the flexibilities are very helpful for code selection (39%) and claims payment (40%). But a closer look at the data for these respondents indicates a mixed bag of results.

CMS: Use CPT rules for counting time for advance care planning

12/21/2015

by: Roy Edroso

A unit of time for advance care planning is attained when the midpoint of the 30-minute service is passed, CMS confirmed during a Dec. 9 open door forum.

Small practices report fuller documentation for ICD-10 diagnosis coding

12/21/2015

by: Richard Scott

You’re likely not receiving the full documentation details you need to code correctly in the ICD-10 era, and that could be hampering your
office’s productivity and success rates.

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